Job Summary

Seeking a highly skilled and experienced Senior Underwriter to join a team in a hybrid work environment. The ideal candidate will be responsible for underwriting, pricing, and managing stop loss insurance programs, with a primary focus on level-funded stop-loss arrangements and traditional specific and aggregate stop-loss policies. This role offers a unique opportunity to manage and grow an established stop loss MGU and its book of business, reporting directly to the Chief Actuarial Officer. The Senior Underwriter will play a critical role in ensuring disciplined risk management, accurate policy administration, and efficient claims and financial oversight.

Compensation Package

Salary: $130,000 - $150,000 (commensurate with experience)
Bonus Structure: Competitive and aligned with experience
Work Environment: Hybrid (combination of remote and in-office work)

Responsibilities

Underwriting & Pricing

Evaluate and price level-funded stop loss programs, including specific and aggregate coverage components.
Underwrite traditional stop loss policies across a range of employer sizes.
Analyze census data, plan designs, claims experience, large claimant disclosures, and risk factors.
Develop and document underwriting rationale in alignment with carrier guidelines and MGU authority.
Present recommendations to stakeholders when required by authority thresholds.
Manage new business quotes, renewals, and mid-year plan changes.
Monitor block performance and adjust pricing strategies as needed.

Portfolio & Risk Management

Assess TPA administrative models to identify adverse selection risks and favorable opportunities.
Track loss ratios and emerging claim trends within the MGU block.
Conduct quarterly renewal projections and profitability analyses.
Maintain underwriting discipline in alignment with reinsurance and carrier agreements.

Policy Administration

Oversee policy issuance, amendments, and contract documentation.
Ensure compliance with carrier agreements and regulatory requirements.
Maintain accurate policy and risk records within underwriting systems.

Claims Oversight

Review and process stop loss claims in accordance with policy provisions.
Interpret contract language to determine claim eligibility.
Collaborate with TPA on large claim reviews and reimbursement timing.
Monitor large claimant activity and update underwriting forecasts accordingly.
Ensure accurate and timely reimbursement processing.

Accounting & Financial Oversight

Reconcile premium billing and remittance reporting.
Coordinate premium accounting with TPA.
Support financial reporting for MGU leadership and stakeholders.

Partner Relations

Serve as a subject matter expert for internal and external stakeholders.
Build and maintain strong relationships with TPA and reinsurance partners.
Support business development initiatives as appropriate.

Qualifications/Requirements

Experience: 7+ years of stop loss underwriting experience (level-funded experience required).
Technical Expertise: Proficiency in underwriting both specific and aggregate stop loss coverage.
Knowledge Base: Strong understanding of self-funded medical plan structures, TPA administration, and stop loss contract provisions (e.g., 12/12, 15/12, 24/12 contracts, aggregating factors, terminal liability).
Analytical Skills: Strong financial acumen with the ability to interpret loss ratio trends.
Technical Proficiency: Advanced skills in Excel and underwriting analytics tools.
Communication: Excellent written and verbal communication skills.

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Senior Underwriter

Job description