Director Core Underwriting

Company :

Highmark Inc.

Job Description : 

JOB SUMMARY

This job is responsible for overseeing end-to-end operations of the designated function within Underwriting, including adherence to timeliness, quality expectations, and applicable internal and governmental regulations. The incumbent communicates daily within the function on work planning, risks, issues, etc and meets routinely with Underwriting leadership to review metrics, performance, and key issues.

ESSENTIAL RESPONSIBILITIES

• Perform management responsibilities to include, but are limited to, involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.
• Plan, organize, staff and direct and control the day to day operations of the department, develop and implement policies and programs as necessary, may have budgetary responsibility.
• Manage relationships between assigned function and other key stakeholders. Provide guidance to underwriting functions as a SME to health plan underwriting. Understand strategic and practical impacts of issues and voices concerns when necessary.
• Ensure integrity and consistent application of Underwriting policies and guidelines for all clients.
• In exception scenarios, reviews renewal and prospect quotes to provide guidance as to whether results are reasonable and appropriate. Recommend modifications to situations that will result in adverse selection and subsequent financial loss.
• Manage intraday workload planning across the function and escalates long-term concerns to appropriate inter-departmental team.
• Other duties as assigned or requested.

EDUCATION

• Bachelor's Degree in Science, Mathematics, Technology or related field

Substitutions

• 6 years of related underwriting experience in lieu of Bachelor degree

Preferred

• None

EXPERIENCE

Required

• 7 years of Health Care Underwriting
• 5 years in a Leadership position

Preferred

• 5 years of applying Advance Mathematics OR in an Actuarial OR Risk Management role

LICENSES or CERTIFICATIONS

• None

Preferred

• None

SKILLS

• Deep understanding of Highmark Health Plan products, services and risk assessment techniques
• Experience with customer relationship management
• Consultative and partnership-driven mindset
• Strong oral and written communication 
• Strong analytical background
• Focus on team skill development

Language (Other than English):

None

Travel Requirement:

25% - 50%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Frequently

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

Occasionally

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

Occasionally

Physical work site required 

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

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.

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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

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