Exemption Status:

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary: The l Stop Loss Underwriter II plays a critical role in assessing and managing risks associated with medical stop loss insurance policies.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Evaluate and underwrite medical stop loss insurance applications, assessing risk factors such as claims history, medical conditions, demographics, and policy provisions.
• Utilize actuarial tools, statistical models, and industry benchmarks to assess the potential risk exposure of each policy and determine appropriate premium rates and coverage limits.  
• Review and analyze policy documents, endorsements, and other relevant materials to ensure compliance with underwriting guidelines, regulatory requirements, and company standards.
• Analyze large volumes of claims data to identify trends, patterns, and emerging risks, providing insights to support underwriting decisions and pricing strategies.
• Collaborate with brokers, agents, and clients to gather additional information, clarify underwriting requirements, and negotiate terms and conditions of coverage.
• Monitor the performance of the medical stop loss portfolio, tracking key performance indicators (KPIs), analyzing loss ratios, and recommending adjustments to underwriting strategies as needed.
• Develop and update underwriting guidelines, policies, and procedures to reflect changes in market conditions, regulatory requirements, and emerging industry trends.
• Implement risk mitigation measures, such as reinsurance arrangements, risk-sharing agreements, and alternative risk transfer solutions, to protect the company's financial interests and minimize exposure to catastrophic losses. Ensure compliance with all applicable laws, regulations, and industry standards governing medical stop loss insurance underwriting activities, maintaining the highest ethical standards at all times

Supervisory Responsibilities        

This job has no supervisory responsibilities.

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).  One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience                                            

Bachelor's degree in business, finance, mathematics, actuarial science, or a related field. Advanced degree or professional certifications are plus  (or equivalent combination of education and experience) a minimum 3+ years’ experience in underwriting or stop loss for health care accounts or equivalent combination of experience.

Computer Skills

To perform this job successfully, an individual should have knowledge of Artificial Analytics tools i.e., Gradient, Verikai,software, internet software and Microsoft Office Suite and Outlook.  

Other Skills and Abilities                                                    

Thorough understanding of medical insurance terminology, concepts, and underwriting principles, with knowledge of regulatory requirements and industry best practices.

Reasoning Ability                                                    

Analytical skills, with the ability to interpret and analyze large datasets, identify trends, and make data-driven underwriting decisions.

Competencies                                              

To perform the job successfully, an individual should demonstrate the following competencies:

• Adaptability - Adjusts quickly to evolving situations by integrating new information, remaining flexible, recognizing and implementing necessary changes and taking advantage of opportunities presented by new developments.

• Communication -Expresses self clearly and effectively in face-to-face interactions, presentations and written documents, and employs active listening skills to ensure productive interactions.

• Initiative - Proactively gathers and analyzes information, assesses situations and identifies challenges and opportunities, sees what needs to be done and takes appropriate action.

• Interpersonal Effectiveness - Demonstrates good people skills by showing a commitment to teamwork, resolving conflicts effectively and with respect for others’ viewpoints, respecting differences and building strong relationships and networks.

• Planning - Produces realistic, effective plans with clear actions and objectives, workable timelines and specific methods to measure progress, taking into account overall goals, required resources and potential obstacles. 

• Reliability - Maintains good record of attendance and punctuality, conscientiously follows through on actions without excessive need for supervision, fulfills commitments.

• Quality Focus - Demonstrates a personal investment in ensuring the quality of products and/or services, going the extra mile to meet or exceed standards.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work Location

REMOTE

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

Working Hours

This is a non-exempt position requiring the incumbent to be able to work overtime from time to time in order to get the job done.  Therefore, one must have the ability to work nights, weekends or on holidays as required.  This may be changed at any time to meet the needs of the business.  The typical working hours for this position is Monday through Friday from 8:00am to 5:00pm.

Travel

This position requires no travel, however, attendance maybe required at various local conferences and meetings.

The Perks:

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

OSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.