Group Rating Quality Specialist

Blue Cross and Blue Shield of Kansas is looking to add to our growing Underwriting team and has a new opportunity for an Underwriting Quality and Tools Analyst. This position ensures the accuracy, efficiency, financial integrity, and continuous improvement of underwriting processes, rating methodologies, and actuarial evaluations supporting group rating and stop-loss analysis. This role focuses on quality assurance, underwriting governance, actuarial support, process optimization, reporting, tool maintenance, and training to support underwriting operations. The analyst leads quality reviews, manages actuarial and underwriting data integrity, evaluates rating methodologies, refines risk assessment tools, assists in system improvements, and collaborates with internal stakeholders to enhance efficiency and compliance. Reporting to the Manager, Underwriting Quality & Tool, this role plays a key part in driving data integrity, automation, and workflow enhancements.

“This position is eligible to work remotely, hybrid or onsite in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.”

Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.

Why Join Us?

• Family Comes First: Total rewards package that promotes the idea of family first for all employees.
• Professional Growth Opportunities: Advance your career with ongoing training and development programs.
• Dynamic Work Environment: Collaborate with a team of passionate and driven individuals.
• Trust: Work for one of the most trusted companies in Kansas
• Stability: 80 years of commitment, compassion and community

Compensation

$99,440 - $124,300

Exempt Grade 17

• Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid.  All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.

What you’ll do

• Oversee and execute quality reviews of Group Rating Intake Tool (GRIT) requests and monthly production work, ensuring accuracy and compliance with actuarial rating methodologies and underwriting guidelines.
• Conduct actuarial, underwriting, and financial impact analysis, including short/long stop-loss period analysis, credibility studies, and underwriting risk assessments to drive data-backed recommendations.
• Develop and implement training materials, procedure manuals, and departmental documentation to ensure standardization and knowledge retention of actuarial methodologies and underwriting practices.
• Identify and implement efficiencies in underwriting workflows, leveraging automation, predictive modeling, and data-driven process improvements to optimize team productivity.
• Develop and deliver technical training on underwriting practices, actuarial methodologies, rating factor adjustments, and risk evaluation techniques.
• Collaborate with internal and external audit teams to support actuarial and underwriting compliance, quality controls, and regulatory reporting.
• Review and validate with final quality reviews for monthly mailings and other underwriting communications to ensure accuracy and clarity.
• Develop, analyze, and maintain rating factors and risk models that support underwriting and actuarial tools, ensuring data-driven decision-making.
• Support SERFF rate filings with the Kansas Department of Insurance (KDOI) ensuring accurate and timely submission of rate justifications and regulatory documents.
• Oversee enhancements to underwriting tools and actuarial databases, ensuring seamless integration of rating models and optimization of underwriting systems.

What you need

• Bachelor's degree in Business, Mathematics, Statistics, Finance, or a related field.
• Minimum of 3 years of experience in underwriting, group rating, actuarial, or quality assurance within the health insurance industry.

Knowledge/Skills/Abilities

• Strong analytical and problem-solving skills to assess underwriting data, quality t