Senior Underwriter Health Insurance

Job Summary

The Senior Underwriter Self-Funded and Stop Loss is responsible for acting as a 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.
• Absess risk and recommend appropriate specific and aggregate stop-loss coverage levels.
• Cookorate 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.
• Maintain account performance and recommend pricing, funding, or plan design adjustments as needed.
• Ensure compliance with company policies and underwriting guidelines.
• Maintain underwriting documentation and 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

• 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
• 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
• 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