Welcome to a team of caring and passionate people who work each day to meet the needs of our members and clients. At Luminare Health (a subsidiary of Health Care Service Corporation), you will be part of an organization committed to offering custom services to self-funded health benefits plans that manage costs – without compromising benefits – by offering innovative solutions, flexibility, transparency and customer support. This is an exciting time to join our team and enhance our culture that emphasizes caring, diversity and inclusion, mutual respect, collaboration and service to our communities. 

Job Summary

The primary purpose of this role is focused on the HB stop loss offering, inclusive of developing the appropriate stop loss carrier network for applicable markets and clients. Owning relationships with preferred vendors, while nurturing non-preferred vendor relationships is a critical component of the position. This position will be the stop loss sales lead, especially for complex cases, and driving overall collaboration with sales to grow stop loss business and with client management to retain and convert to HB stop loss placements.

Internally this position works closely with client management, sales, healthcare management, managed care, proposal team, and claims. This position also provides support to Underwriting team. Externally this position interacts with stop loss carriers, brokers, and potentially key accounts.

The role will also lead a monthly cadence to review cases and assess for sales pipeline opportunities to continuously grow the stop loss business. Developing the stop loss offering to have a program that matches capabilities with as a source for new growth. Nuances for different markets will require engagement with stop loss carriers to determine the appropriate offering. (ER TPA, DTE, Tribal, etc)

The Director of Underwriting & Stop Loss will be the SME to the business and leadership and may advise regarding program incentives and fee structures that will lead to stop loss program growth.

A key responsibility of this position is to provide underwriting support for overall new business prospects and renewal self-funded clients. This position focuses on pricing strategy to win new business and retain clients. Works collaboratively with stop loss carriers to maximize account retention and new business sales by obtaining the best possible rates for the client or prospect. In addition, this position leads, manages, audits a team of Sr Managers of Underwriting, Senior Underwriters, and Underwriting Executives.

• Acting as the stop loss sales lead, especially related to complex cases.
• Focusing on managing with Sales team all new Opportunity Stop Loss placement and assisting Client Management on complex renewal cases and presentation of case to carrier(s)
• Focusing on determining alternative paths to getting data that Stop Loss carriers require to quote new opportunity.
• Acting as a resource for Sales and Client Management in moving Broker placed Stop Loss to Health Benefits direct placement.
• Leading monthly cadence and strategizes with client management, sales, and leadership to meet growth and retention goals. 
  • Prioritizing cases that should be targeted to move Stop Loss from Broker placed to Health Benefits placed.  Create action plan for each case to approach Broker to sell placement by Health Benefits.
  • Prioritizing cases that should be consolidated to preferred Stop Loss carriers to improve override revenue and improve Health Benefits position within carrier panel.   Identify which carriers each case should be discussed with and strategy for placement.
  • Reviewing list of cases that are not placed by Health Benefits and do not have integration fee to ensure that the waiving of integration fee is appropriate action.   Determine if the integration fee set for non-preferred carriers is set at the appropriate level.   Any waiver of integration fees needs to be approved by the U/W – Stop Loss Director
  • Ensuring Client Management has broader access to the Stop Loss claims team to discuss potential Stop Loss issues prior to them reaching escalation point.
• Ensuring that any pricing changes as the renewal moves from UW to Client Services is approved and documented across the enterprise.  Recommend not to allow client services to change pricing once it has passed through the Underwriting / pricing process.  If change is required it must be reviewed and approved by Client Management, Finance, and U/W – Stop Loss Director.   Documentation must occur regarding change in pricing.
• Identifying cases that may have high probability of significant rate increases or other stop loss carrier action and create action plan and proactive data plan to manage Stop Loss renewal.  Engage Stop Loss New Business / Complex Case Lead to assist in