Delivery You Can Count On
As a member of our Claims Connect team, you'll help process and deliver the claims information Kaiser Permanente's members, providers, regulators, and customers need, and expect, from a world-class health care organization.
Healthcare Senior Underwriting ConsultantLocation: Oakland, CA Additional Locations:
Seattle Job Number: 771434 Date posted: 02/11/2019
Anticipate key business, marketplace and competitor dynamics in developing and implementing strategies to optimize business results which include retention and growth targets while mitigating risk. Primary focus is on establishing the appropriate rate and conditions of offering to achieve revenue, membership and margin goals. Additionally, processes and policies are managed to support optimal customer service while collaborating with Sales/Account Management partners to optimize business opportunities and effective solutions.
- Partner with Sales and Account Management and other key internal stakeholders to create and execute a business plan that optimizes our opportunities across book of business.
- Produce accurate quotes in compliance with Underwriting and authority guidelines and state&federal laws for existing and prospective business.
- Develop and execute account and/or book of business plans to ensure attainment of goals primarily on complex cases.
- Lead peer review including the most complex cases to ensure accuracy&appropriateness of quote.
- Manage business processes and policies that support for all job levels particularly in areas of rate actions, benefit structure, customer engagements, etc.
- Meets established department turn around goals by balancing deadlines.
- Designs new and interpret existing policies, procedures, and methodology.
- Develop and leads in the implementation of continuous quality improvement programs.
- Strategically partner with&influence Actuarial Services and other internal customers to ensure KP business processes are in alignment with organizational and external customer goals when approppriate.
- Ensure Underwriting is an integral partner in the creation of effective business solutions.
- Establish and leverage relationships with Sales/Account Management and external customers that optimizes business potential with purchasers, brokers&consultants.
- Develop creative solutions that maximize credibility with customers&Sales/Account Management and external customers.
- Proactively acquire&exhibit knowledge of the external business environment to add value.
- Provide leadership to the team.
- Create and maintain positive, empowering work environment.
- Act as a role model.
- Coach and develop team members.
- Minimum seven (7) years of experience in rating, underwriting, marketplace evaluations, and/or financial analysis in a managed care environment.
- Bachelor's degree required in business administration, health care administration, mathematics, statistics, OR four (4) years of experience rating, underwriting, marketplace evaluations, and/or financial analysis in a managed care environment.
License, Certification, Registration
- Experience creating client presentations using Microsoft Office programs and use of client databases,
- Experience using effective verbal and written communication skills.
- Experience in interpersonal, presentation, and persuasion skills.
- Experienced in meeting individual business objectives.
- Previous experience with employee group benefits.
- Proficiency in computer and analytic skills.
- Proficiency and understanding of underwriting processes, healthcare products, and contracts.
- Demonstrated customer service skills with the ability to articulate and respond to highly complex issues.
- Minimum eight (8) years of quantitative analysis experience preferred.
- Experience in Large Group Underwriting preferred.
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.
About Insurance & Claims Careers
Careers in Insurance & Claims
Our insurance and claims teams are committed to meeting customer and member expectations when it comes to the timely and accurate processing of claims, while remaining in compliance with federal, state, and local laws, as well as regulations and rules. Make an impact as you contribute to the implementation of contemporary technology in areas such as claims quality, claims operations, business analysis, processing, configuration, reporting, and more.
See What People are Saying About Working at KP
Sep 16, 2018
"Great place to spend a work day"
- Positive Outlook
- Approves of CEO
I have been working at Kaiser Permanente full-time (More than a year)
Friendly professional people who share insights and work together for improvements and success. Excellent pay and good employee recognition programs.Full Review
Come introduce yourself to a member of the Kaiser Permanente team at an upcoming career or professional event. We look forward to meeting you in person.
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