Director, Individual Underwriting & New Enrollment

Company Description: Do something amazing everyday. And call it a career.Making a difference in people's lives. Caring about our neighbors. And working together to protect the health and well-being of more than 8 million Floridians. This is Blue Cross and Blue Shield of Florida and its subsidiaries, and this could be you - doing something amazing everyday.Job Description:
Job duties included but are not limited to the following:
Provide financial and business leadership within the Individual (Under-65) market related to Medical Underwriting and Enrollment

Responsible for achieving financial, enrollment and service objectives through efficient, effective and customer-focused medical underwriting and enrollment processes

Work collaboratively with the Individual and Small Group Market Segment Team (MST) in developing and implementing strategic direction/vision for the Individual (Under-65) market

Monitor and analyze competitors' medical underwriting practices and ensure there are competitive business rules and underwriting guidelines

Develop unique and robust strategies and solutions that will differentiate the organization and continuously benchmark performance against the competition

Regularly monitor competitiveness within risk categories

Develops processes that are integrated with risk assessment

Ensure that appropriate financial controls and monitoring capabilities are in place (monitoring durational loss ratios, high cost claims, potential misrepresentation, pre-existing conditions, etc.); determine needs for corrective actions

Responsibility for misrepresentation and recession process, ensuring the process is efficient

Monitor service level metrics (cycle times, issue and rejection rates, quality outcomes, etc.); determine needs for corrective actions

Ensure that there is a fully integrated sales/underwriting/ enrollment platform

Responsible for coordinating actions between Medical Underwriting and Actuarial

Ensure that medical underwriting and field underwriting guidelines are periodically reviewed and updated to ensure competitiveness, changes in medical technology and achievement of targeted risk selection

Responsible for hiring, training, and development of underwriting and enrollment staffJob Requirements:

Bachelor's degree or equivalent experience to include 10+ years underwriting experience in the healthcare industry

5+ years experience leading and managing an Individual Underwriting unit with proven ability to build and manage effective teams
Keywords:
Underwriting, New Enrollment[gj.663880.10.443294]Job Requirements
Job Requirements continued:

Possess excellent communication, collaboration and relationship management skills dealing with internal and external customers

Demonstrated ability to develop and execute strategy by influencing internal and external constituents

Proven ability to develop and execute strategies and achieving successful results

Excellent planning, coordination and integration skills

Successful work experience in a matrix management environment with the ability to work across organization with key process owners

Proven ability to support and lead transformational change initiativesFor consideration, please visit our website at