Medical Stop Loss Underwriting Consultant

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Medical Stop Loss Underwriting Consultant

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Medical Stop Loss Underwriting Consultant

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PA, Working at Home - Pennsylvania

Company :

HM Insurance Group

Job Description :

JOB SUMMARY

This job participates on a multi-disciplinary team focused on highly visible, complex broker and/or TPA relationships that are organized into blocks. Some direct client interaction, but primary client contact is the sales leadership. Manages a block of stop loss business and case level underwriting within the block to achieve overall goals. Operates in a matrix structure working with the Sales, Underwriting and Clinical teams and oversees all aspects of new business and renewal pricing and risk analysis associated with select clients. Responsible for the P/L, renewal metrics and new business sales for the block. Expected to provide creative solutions on a case level and assists in the development and execution of creative solutions at the block level. Provides leadership and training to other underwriters supporting programs.

ESSENTIAL RESPONSIBILITIES

• Responsible for underwriting new and renewal business within an assigned block. Use rating manual, experience module and clinical expertise to create pricing that drives P/L, renewal metrics and new business sales for assigned block.
• Collaborate with Sales, Underwriting and Clinical to develop and implement pricing actions that will help HMIG meet financial targets.
• Train, coach and provide experiences to lower level staff with the purpose of expanding consultative best practices throughout the department.
• Utilize client and market knowledge to expand/enhanced Underwriting Guidelines, processes and tools by incorporating best practices.
• Monitor overall block performance and report on emerging financial trends. Develop strategies and tactics to move case level and block results to meet targets.
• Act as subject matter expert to support Sales" negotiations to renew existing clients and enroll new business.
• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor"s Degree in Mathematics, Actuarial Science, Finance, Business Administration/Management or Computer and Information Science

Substitutions

• 6 years of experience in lieu of degree

Preferred

• None

EXPERIENCE

Required

• 10 - 15 years in Underwriting

Preferred

• 10 - 15 years in the Insurance Industry

LICENSES AND CERTIFICATIONS

Required

• None

Preferred

• Certified Employee Benefit Specialist (CEBS)
• Health Insurance Associate (HIA)
• Managed Healthcare Professional (MHP)
• Society of Actuaries

SKILLS

• Creative Thinking
• Risk Management
• Relationship-builder with Unsurpassed Interpersonal Skills
• Conflict Management
• Solution Recommendations
• Analytical Skills

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$94,200.00

Pay Range Maximum:

$151,000.00

Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Recruitment Fraud Alert

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Job Details

• Job category Finance
• Position Type Full Time
• Posted 07/30/2026
• Location(s) PA, Working at Home - Pennsylvania
• Line of Business
• Entity
• Recruiter
• Hiring Manager
• Experience Level
• Job Family Underwriting-HM
• Req ID J285459

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Highmark Health is an independent licensee of the Blue Cross Blue Shield Association.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org.

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