Calculates premium rate proposals and develops product portfolios for new client groups and renewal business. Contributes to the achievement of the financial and marketing objectives for the thorough assessment of group risk, the expected cost to deliver services, the expected marketability and competitiveness of health care services that will result in profitable enrollment. Uses actuarial data in standard application of various rating methodologies and formulas and identifies potential areas for application of underwriting judgment. Confers with management to identify and develop methods and procedures to obtain greater efficiency. Provides support to Management relative to financial forecasting, profitability and expense analysis, and assigned special projects.

• Analyze the risk of a group and calculate premium rates for new and renewal clients adhering to regulatory requirements, underwriting guidelines and pricing strategies to achieve target financial results.
• Analyze claims experience, demographics, benefit plans, group attributes and competitor data. Applies underwriting judgment as appropriate.
• Complete Request for Proposals providing explanations of rate action, configuration of benefits and market position to sales, client, broker, or consultant. Organizes proposal questionnaire responses to consulting firms.
• Presents key accounts to all levels of management providing an explanation of premium rating strategies, product offerings and market position specific to the account.
• Conducts conference calls with the clients and sales to interpret the renewal and new business proposal rating, negotiating premium reductions as part of these calls.
• Assists with designing and implementing rating models. Recommends measures to improve efficiency and ensure accuracy.
• Acts as a department resource for co-workers, sales, and inter-departmental projects
• Assists in preparing various management reports to analyze the financial risk for the health plan. Utilizes a high level of experience in Excel and reporting programs for special analysis

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

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