Lead Risk Analyst

Transforming healthcare for small businesses

At Optimyl Benefits, we are dedicated to reshaping the healthcare sector for small employers by offering accessible, high-quality, and user-friendly healthcare solutions. With extensive experience in serving small employers, Optimyl crafts plans tailored specifically to their needs, achieving the ideal balance for our clients. Our ambitious mission is already making a significant impact. Through our innovative offerings, we enable businesses to provide competitive benefits packages that enhance the well-being of their employees and their families. By becoming part of our organization, you will have the chance to create a meaningful difference while developing your skills alongside a supportive and skilled team.

Position Summary

Optimyl Benefits is on the lookout for a Senior Underwriter to evaluate, price, and analyze the structure of contracts and policies for group employers based on demographics, medical assessments, claims history, and other unique risk factors. The role includes:

• Exercising discretion within Underwriting authority according to Optimyl's policies while ensuring sustainable profitability and growth.
• Determining when to reject quotes that do not align with Optimyl's strategic goals and risk framework.
• Assessing risk factors for new business enrollments, annual renewals, and amendments in accordance with established underwriting guidelines and standards.
• Reviewing relevant policies, guidelines, and market data to enhance risk management, secure appropriate enrollments, or manage existing memberships.
• Evaluating data such as the financial health of organizations, participation rates, industry types, and individual participant characteristics from past claims to establish available benefits and set rates.
• Generating various reports and providing rationale and support to other departments within the organization regarding underwriting outcomes, rate calculations, and financial activities.
• Delivering expense estimates and precise analyses of financial documents.
• Possessing knowledge and experience with Optimyl's procedures, policies, and protocols.
• This is a mid-level role with minimal oversight from management while executing essential responsibilities.

Key Responsibilities:

• Managing a portfolio of renewing accounts and writing new business at profitable levels to assist Optimyl in achieving overall business objectives.
• Utilizing various systems, tools, and resources to gather necessary data and accurately complete and monitor assigned tasks.
• Assessing group eligibility and participating employees during new business quotes; evaluating eligibility for mid-year additions of participating employees.
• Calculating rates, analyzing different financial arrangements (e.g., networks, plan designs, carveouts), interpreting pricing policies, and adapting to unique circumstances.
• Identifying questionable claim patterns among renewal clients and assessing competitors' claims experiences for prospective clients, developing recommendations accordingly.
• Applying corporate risk management policies and adjusting for unique situations that may not have been included in standard pricing formulas.
• Recognizing when clients fail to comply with corporate risk management policies, disclosure requirements, or enrollment criteria.
• Enforcing Optimyl's business regulations (participation, product availability, etc.).
• Recommending suitable adaptations of pricing within the relevant policies or guidelines to address each client-specific scenario.
• Analyzing individual member risks and aggregating them to the total group.
• Supporting other internal initiatives, which may include underwriting policies and procedures, training, fraud detection, corporate compliance, and product development efforts.
• Completing renewals, prospective quotes, and reviewing the work of lower-level analysts (Underwriting Assistants) in line with production and timeliness standards.
• Adapting to shifting priorities as quotes are received from various markets and adjusting to new requirements.
• Communicating recommendations for policy adaptations to accommodate client-specific situations or changes to overall policy, supported by clear rationale or management principles.
• Serving as a subject matter expert to sales and account management teams.
• Influencing the Sales team and external stakeholders toward appropriate risk solutions.
• Guiding the Sales team regarding the appropriate pricing and structure of each quote and influencing other market partners, such as brokers, when necessary.
• Providing guidance, assistance, and technical support to junior analysts.
• As assigned, taking primary responsibility for maintaining departmental tools and processes.
• As assigned, representing departmental perspectives and needs on system development and process improvement teams.

Required Education:

• Bachelor's degree in mathematics, Actuarial Science, Finance, Business, Computer Science, or a related quantitative analysis field.

or

• 6 years of relevant progressive experience.

Required Experience:

· 3 - 5 years in Underwriting self-funded and converting fully insured prospects into self-funded clients.

Competencies and Skills:

• Proficient and knowledgeable interaction with various internal departments and external stakeholders.
• Ability to utilize applicable computer systems and applications effectively.
• Capability to work independently and take responsibility for projects ranging from routine to highly complex.
• Demonstrating an understanding and support of corporate and departmental goals and initiatives.
• Exhibiting ethical business practices with adherence to all privacy and confidentiality policies and regulations.
• Strong problem-solving, organizational, and negotiation skills.
• Excellent mathematical aptitude required for analysis.

Why Choose Optimyl?

At Optimyl Benefits, we are committed to delivering affordable, high-quality, and user-friendly healthcare plans for small employers. We are passionate about making a difference and seek talented individuals who share our vision. Here are some reasons to consider joining our organization:

1. Competitive Compensation and Benefits: We provide a competitive salary and an attractive benefits package, including life insurance, vision, dental, and medical coverage, along with a 401K plan featuring employer matching.
2. Growth Opportunities: We believe in nurturing talent and supporting our team members' professional development. At Optimyl, you will have the opportunity to grow with the organization and make a lasting impact on our mission.
3. Collaborative Environment: Our workplace fosters collaboration and open communication. We value every team member's input and strive to create a culture that encourages contributions from all, without unnecessary hierarchy.
4. Flexible Work Arrangements: We recognize the importance of work-life balance and offer flexibility to accommodate our team members' needs and preferences.
5. Generous Leave Policies: Our employees benefit from 11 paid holidays annually, 15 days of paid vacation, and 8 days of paid sick leave. We believe that providing ample time off is essential for maintaining productivity and overall well-being.

At Optimyl Benefits, you will be part of a dedicated team working towards a meaningful mission. We are driven by our passion for providing accessible and top-quality healthcare plans and are always looking for talented individuals who share our vision. If you are ready to make a difference and grow with us, we would be delighted to have you on board.

Optimyl Benefits is an equal opportunity employer. We are committed to fostering a diverse and inclusive work environment and welcome applicants from all backgrounds, regardless of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other characteristic protected by applicable law.