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Medical Stop Loss Underwriting Consultant

HM Insurance Group

  • Company Reinsurance Solutions
  • Pittsburgh, PA
  • Finance
  • Full time
  • Day (United States of America)

Company :

HM Insurance Group

Job Description : 


This job participates on a multi-disciplinary team focused on highly visible, complex broker and/or TPA relationships that are organized into blocks. Some direct client interaction, but primary client contact is the sales leadership.  Manages a block of stop loss business and case level underwriting within the block to achieve overall goals. Operates in a matrix structure working with the Sales, Underwriting and Clinical teams and oversees all aspects of new business and renewal pricing and risk analysis associated with select clients. Responsible for the P/L, renewal metrics and new business sales for the block. Expected to provide creative solutions on a case level and assists in the development and execution of creative solutions at the block level. Provides leadership and training to other underwriters supporting programs.


  • Responsible for underwriting new and renewal business within an assigned block.  Use rating manual, experience module and clinical expertise to create pricing that drives P/L, renewal metrics and new business sales for assigned block.
  • Collaborate with Sales, Underwriting and Clinical to develop and implement pricing actions that will help HMIG meet financial targets.  
  • Train, coach and provide experiences to lower level staff with the purpose of expanding consultative best practices throughout the department.
  • Utilize client and market knowledge to expand/enhanced Underwriting Guidelines, processes and tools by incorporating best practices.
  • Monitor overall block performance and report on emerging financial trends.  Develop strategies and tactics to move case level and block results to meet targets.
  • Act as subject matter expert to support Sales' negotiations to renew existing clients and enroll new business.
  • Other duties as assigned or requested.



  • Bachelor's Degree in Mathematics, Actuarial Science, Finance, Business Administration/Management or Computer and Information Science


  • 6 years of experience in lieu of degree


  • None



  • 10 - 15 years in Underwriting


  • 10 - 15 years in the Insurance Industry



  • None


  • Certified Employee Benefit Specialist (CEBS)
  • Health Insurance Associate (HIA)
  • Managed Healthcare Professional (MHP)
  • Society of Actuaries


  • Creative Thinking
  • Risk Management
  • Relationship-builder with Unsurpassed Interpersonal Skills
  • Conflict Management
  • Solution Recommendations
  • Analytical Skills

Language (Other than English):


Travel Requirement:

0% - 25%


Position Type


Teaches / trains others regularly


Travel regularly from the office to various work sites or from site-to-site


Works primarily out-of-the office selling products/services (sales employees)


Physical work site required


Lifting: up to 10 pounds


Lifting: 10 to 25 pounds


Lifting: 25 to 50 pounds


Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

EEO is The Law

Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity ( )

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