Senior Underwriter Health Insurance

Job Description

Job Description

Description:

Job Summary:

The Senior Underwriter Self-Funded and Stop Loss is responsible for acting as subject matter expert for the underwriting function for Administrative Services Only (ASO) and self-funded health plan business. This role provides strategic oversight of new business, renewals, risk assessment, and stop-loss placement while ensuring underwriting profitability, growth, and operational excellence. The position serves as a resource for underwriting team members, establishes underwriting standards and best practices, and serves as a liaison to leadership.

Duties and Responsibilities:

• Lead and oversee all underwriting activities for ASO and self-funded health plan clients, including new business, renewals, and existing account performance.
• Advise and mentor junior underwriters as a senior resource / SME, offering day-to-day guidance and technical support to foster professional development and underwriting consistency.
• Evaluate new business and renewal opportunities for ASO and self-funded employer groups
• Analyze medical, pharmacy, and ancillary claims experience, utilization trends, and demographic data
• Develop financial projections, renewal recommendations, and ASO fee pricing
• Assess risk and recommend appropriate specific and aggregate stop-loss coverage levels
• Coordinate with stop-loss carriers to obtain quotes, negotiate terms, and manage underwriting requirements
• Review large claimant activity and emerging risk trends to support accurate pricing decisions.
• Prepare underwriting reports, proposals, and financial analyses for clients and internal stakeholders
• Collaborate with sales and account management teams to support RFP responses, client presentations, and finalist meetings
• Monitor account performance and recommend pricing, funding, or plan design adjustments as needed
• Maintain underwriting documentation and ensure compliance with company policies and underwriting guidelines
• Ensure compliance with state and federal regulations, including healthcare legislation changes by maintaining up-to-date knowledge of regulatory changes.
• Develop underwriting reports, forecasts, and presentations.

Requirements:

Required Knowledge, Skills, and Abilities:

• Bachelor's degree in Business, Finance, Mathematics, Actuarial Science, Healthcare Administration, or a related field 
• 5+ years of underwriting experience in underwriting of self-funded health plans, ASO administration, employee benefits, or stop-loss insurance.
• Strong knowledge of medical and pharmacy claims analysis, healthcare funding arrangements, and stop-loss underwriting principles
• Advanced proficiency in Microsoft Excel and financial modeling tools
• Strong analytical, communication, and relationship management skills
• Solid working knowledge of standard computer applications including MS Word, Excel, Outlook, and PowerPoint
• Ability using a computer which includes expert keyboard and navigation skills and learning new programs
• Communicate clearly and professionally with internal and external customers
• Work effectively individually and as part of a team to achieve established outcomes. Understand other’s roles and empower one another to take responsibility to be successful.
• Demonstrate collaborative interactions with peers to reach a common goal as well as be a resource to team members and internal/external customers
• Pay close attention to detail in all aspects of the job
• Make decisions using available resources and sound judgment 
• Maintain confidentiality and discretion
• Identify and resolve problems in a timely manner, gather and analyze information skillfully and proactively
• Share knowledge with associates by effectively communicating and providing follow-up
• Open to other’s ideas and exhibits a willingness to try new things.
• Demonstrate accuracy and thoroughness; monitor work to ensure quality.
• Prioritize and plan work activities to use time efficiently.
• Adapt to changes in the work environment, manage competing demands and is able to deal with frequent changes, delays, or unexpected events.
• Follows instructions, responds to direction, and solicits feedback to improve.
• Act in such a way to instill trust from management, other associates, as well as customers.

Physical and Cognitive Demands: The demands described here are representative of those necessary for an employee to successfully perform the essential functions of this job. Reasonable accommodation can be made to enable individuals with disabilities to perform the essential functions.

• Constant: Talk, hear, speak, and use hands and fingers to operate a computer, telephone, keyboard/mouse; occasionally move about the office
• Constant: Visual ability such as close vision, distance vision, color and peripheral vision, depth perception and ability to adjust focus.
• Occasional: Light to moderate lifting is required – this should almost never be used
• Occasional: Lift and/or move up to 10 pounds
• Constant: Regular, predictable attendance is required
• Constant: While performing the duties of this job, the employee is regularly sitting for the full shift.
• Constant: The cognitive skills needed to complete tasks include abilities such as learning, remembering, focusing, categorizing, and integrating information for decision making, problem-solving, and comprehending. 

Work Environment: The work environment described is representative of what must be met by an employee successfully to perform the essential functions of this job.

• The physical environment is indoors in a controlled climate, office setting. The noise level may be low to moderate.

The duties described are representative, but not restrictive of tasks that may be assigned or of the abilities required to do the job. The description is subject to change at any time. Other related duties may be assigned. This description does not alter the at-will status of employment.