Chief Manager - Medical Underwriting - Health Insurance

We have 1 very urgent position in one of the best BFSI brand :

POSITION - Chief Manager - Medical Underwriting

LOCATION :- Gurgaon

LEVEL : Chief Manager

REPORTING : AVP

REPORTEEs : 12 on rolls manpower team.

CTC : negotiable ( depending upon current package, experience, education, interview status )

JOB DESCRIPTION:-

Key Roles & Responsibilities

Primary Role Description

Responsibilities and Duties: -

The underwriting manager is primarily responsible for providing leadership, support and guidance to the underwriting team. He is in charge of ensuring that the underwriting team complies with the goals, objectives and standards of the organization in order to meet customer satisfaction and deadlines. He does this by interpreting the market, customers, experience and translating the findings and learnings into underwriting guidelines. The underwriting manager assesses the risk posed to the company and decides on ways to mitigate them.

Desirable Qualities: -

- An underwriting manager should be decisive & creative. He/She should be able to make quick decisions and have good judgment and analytical skills. He/She should also have excellent verbal and written communication skills and strong negotiation skills.He/She should be open to embracing change and be able to manage it.

Key Roles & Responsibilities:

1) People Management:

- Work appraisals and growth of team

- Training, Coaching & Mentoring.

- Conflict resolution.

- Attrition management.

2) Process Management:

- Evaluation of prevail underwriting practices & market comparison & analysis of data to help revise UW guidelines.

- Approval & processing high value prospects.

- Alignment with cross functional key opinion holders.

- Own interdepartmental queries & issues management/resolution.

- Intra department audits/ error rates.

- Owner of departmental audit and responsible for resolution and of process adherence.

3) Managing health advisor as well as other partners involved in sourcing.

4) Responsibility & authority holder for approvals & non-financial deviations.

5) Branch visit & advisor interaction as well as interface for underwriting representation.

6) Map & maintain SLA (Service Level Agreement) & TATs (Turn Around Times).

7) Owner of underwriting system & rules integrated with sourcing interfaces.

8) Owner of UAT (User Acceptance Testing).

9) Key opinion holder for cross functional alignment & projects. Gathers and prepares preliminary clinical and medical analysis based on information from historical claims utilization data.

2. Develops/prepares reports and assists in the development of new/revised policies and guidelines based on utilization and clinical trends.

3. Assists in the administration of assigned programs. Develops, maintains, audits and reviews functional databases and identifies inconsistencies.

4. Prepares clinical and medical recommendations based on data summaries, trend analysis, financial analysis, and business analysis.

5. Provide support to rate development through timely and accurate clinical and medical analysis to ascertain future risks and support the underwriting and risk management decision.

6. Provide clinical and medical underwriting for the health and life product.

7. Provides clinical and medical underwriting analysis for pricing and risk assessment selections and eligibility including financial, business, and trend analysis of data critical for decision making in achievement of business objectives.

8. Prepares clinical and medical analysis based on employer group utilization and claims data and coordinates with the appropriate wellness, medical and case management and FHP specialty teams to address these identified risks.

9. Assist and provides clinical and medical analysis on Actuarial research and studies and product development initiatives.

10. Prepares and may do presentations. Participates in cross-functional teams to develop new/enhanced systems/processes/programs/policies to support business needs.

11. Performs other duties that may be assigned from time to time.

Key Requirements - Education & Certificates

- MBBS preferred/ BDS, BHMS, BUMS

- Other certifications are welcome

- Proficient user of Microsoft Office packages (Excel, Word, PowerPoint, Access)

Key Requirements - Experience & Skills -

- Minimum 4 years of experience in case he/ she is a MBBS.

- Minimum 10 years of experience in case BDS/ BHMS/ BUMS.

- Good communication skills

- Proactive

- Problem solving

- Good interpersonal skills

- Good customer orientation

- Result oriented

- Effective team player. With very good interpersonal relationship skills and can work and relate well with co-employees, patients and customers.

- Must have the behavioral sensitivity, maturity, diplomacy and tact in addressing complex situations.

- Strong ethics and a high level of personal and professional integrity.

Candidates who have been previously placed by TRUSTKLUB are requested to ignore. As a policy TRUSTKLUB does not intend to offer any candidate from an organisation with whom we are partners . Incase you are an unintended recipient by any means, where in both our firms are in partnership, request you not to apply to this position.

We will call you back if your cv matches the criterion of the client. Please mention your current CTC and current LOCATION details, for candidates who want to relocate, pls mention reason for the same.

TCPL