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About the Role
The Senior Underwriter Self-Funded and Stop Loss acts as a subject matter expert for the underwriting function of 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, ensuring underwriting profitability, growth, and operational excellence. It also serves as a resource for underwriting team members, establishes underwriting standards and best practices, and acts as a liaison to leadership.
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.
- 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.
- Maintain underwriting documentation and ensure compliance with company policies and underwriting guidelines.
- Ensure compliance with state and federal regulations, including healthcare legislation 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 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 to use a computer with expert keyboard and navigation skills and learn new programs.
- Communicate clearly and professionally with internal and external customers.
- Work effectively individually and as part of a team.
- Demonstrate collaborative interactions with peers.
- Pay close attention to detail.
- Make decisions using available resources and sound judgment.
- Maintain confidentiality and discretion.
- Identify and resolve problems in a timely manner.
- Share knowledge with associates.
- Be open to other’s ideas and exhibit a willingness to try new things.
- Demonstrate accuracy and thoroughness.
- Prioritize and plan work activities to use time efficiently.
- Adapt to changes in the work environment.
- Follow instructions, respond to direction, and solicit feedback to improve.
- Act in a way that instills trust.
- 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.
Skills
- Underwriting
- Self-funded health plans
- ASO administration
- Stop-loss insurance
- Medical claims analysis
- Pharmacy claims analysis
- Healthcare funding arrangements
- Stop-loss underwriting principles
- Microsoft Excel
- Financial modeling
- Analytical skills
- Communication skills
- Relationship management
- MS Word
- MS Outlook
- MS PowerPoint
- Computer proficiency
- Teamwork
- Problem-solving
- Attention to detail
- Decision making
- Confidentiality
- Adaptability
Work Type
- Office setting
Experience Level
- 5+ years
Education Level
- Bachelor's degree
About the Company
- 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.