
Website United HealthCare
Job Description:
Positions in this job family are related to determining premium rates. This function uses underwriting principles, financial and statistical modeling, and trend projections to lead and/or support the development of the organization’s pricing and rate setting process. This function analyzes risks and selects proper categories and rates. The distinction between pricing and underwriting versus actuarial is underwriting is the sales side determining premiums. Positions in this function are responsible for assessing and pricing the financial risk associated with group or individual prospective and renewing cases.
Job Responsibilities:
- Apply appropriate rating (e.g., manual; experience; or expense rates) consistent with set guidelines (e.g., state and federal mandates; internal guidelines) and assessed risk (e.g., medical conditions; demographic characteristics) to determine final pricing
- Provide support to the underwriting process (e.g., create file folders, case assignments)
- Demonstrate understanding of new products and services in order to provide customers with appropriate solutions
- Seek approval from appropriate level of management for pricing recommendations as needed
- Uses pertinent data and facts to identify and solve a range of problems within area of expertise.
- Compare recommended coverage and pricing with competitive data to maximize competitive advantage while maintaining profitability
- Demonstrate understanding of relevant systems and software applications (e.g., Word; Excel; pricing tools) used to determine pricing
- Perform financial reconciliations using appropriate tools on alternate funding arrangements, monthly fees, and/or policy year expenses
- Evaluate customer eligibility based on various criteria (e.g., credit worthiness; size; location; funding; credibility of information)
- Provides explanations and interpretations within area of expertise.
- Prioritizes and organizes own work to meet deadlines.
- Determine the availability of the plan designs in order to identify whether the product is acceptable to sell per regulations and guidelines (e.g., Product Availability Grid)
- Provides explanations and information to others on topics within area of expertise.
- Determine and gather the information required in order to manage and assess risk
- Maintain knowledge of market trends, competitiveness compared to other carriers, and/or industry changes in order to make effective pricing decisions
- Understand and apply appropriate mathematical formulas (e.g., to determine rates, assess risk, determine financial impact)
- Ensure compliance with relevant processes, procedures, and regulations (e.g., operating within filed pricing and filed rating formulas; state and federal guidelines)
- Investigates non-standard requests and problems, with some assistance from others.
- Analyzes and investigates.
- Assess the impact of benefits changes (e.g., to determine rate, pricing change, plan type)
- Input relevant data into rating tools (e.g., claim projection template; manual tools; expense formula)
Job Requirements:
- Ability to keep all company sensitive documents secure (if applicable)
- Reside within Cypress, CA
- Ability to work an 8 hour shift between 8:00am – 5:00pm including the flexibility to work weekends and occasional overtime per business need
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Full COVID-19 vaccination is an essential job function of this role.
- Excellent communication skills, both orally and in writing.
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Qualification & Experience:
- Experience with Microsoft Excel (creating spreadsheets and formulas), Microsoft Word (creating documents) and Microsoft Outlook (drafting emails, calendar management)
- Bachelor’s Degree (or higher) in Math, Finance, Business or related degree.
- 1+ years experience in underwriting
Job Details:
Company: United HealthCare
Vacancy Type: Full Time
Job Location: Cypress, CA, US
Application Deadline: N/A
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