Underwriting Manager | Avera Health Plan

Avera Health Plans

Worker Type:

Regular

Work Shift:

Day Shift (United States of America)

Pay Range:

The pay range for this position is listed below. Actual pay rate dependent upon experience.

$82,160.00 - $123,240.00

Position Highlights

Position is located in Sioux Falls, SD. May be eligible for a relocation bonus!

You Belong at Avera

Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

A Brief Overview

The Underwriting Manager is responsible for overseeing and executing underwriting functions to support the Avera Health Plans product offerings. This role involves assessing risk, developing rate methodologies, and ensuring compliance with regulatory requirements. The Underwriting Manager will work collaboratively with internal stakeholders such as product, sales, and finance.

What you will do

• Develop and implement underwriting guidelines, processes, and procedures.
• Analyze and evaluate risk factors to establish appropriate premium rates.
• Review and approve underwriting decisions within designated authority limits.
• Conduct risk assessments for group and Medicare Supplement health plan accounts.
• Provide insights on risk profiles and recommend strategies to mitigate adverse selection.
• Support the development of underwriting models in collaboration with internal/external actuarial services.
• Partner with sales and marketing teams to support new business opportunities and renewals.
• Provide detailed analysis and reporting on underwriting decisions to internal stakeholders and prepare regular reports on underwriting performance and risk trends for leadership review.
• Work with the compliance team to ensure adherence to regulatory standards and Identify opportunities to enhance underwriting processes and implement best practices.
• Analyze claims experience and trends to inform underwriting decisions and contribute to forecasting and budgeting processes by providing underwriting insights.

Essential Qualifications

The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.

Required Education, License/Certification, or Work Experience:

• Bachelor's in business, finance, actuarial science, or a related field.

Preferred Education, License/Certification, or Work Experience:

• Master's in business, finance, actuarial science, or a related field.
• Associate of the Society of Actuaries (ASA) - Society of Actuaries (SOA) Upon Hire or
• Fellow of the Society of Actuaries (FSA) - Society of Actuaries (SOA) Upon Hire or
• Registered Health Underwriter (RHU) - The American College of Financial Services Upon Hire or
• Certified Risk Manager (CRM) - The National Alliance for Insurance Education & Research Upon Hire
• 4-6 years Experience in health insurance underwriting, with a focus on risk assessment.
• Comprehensive knowledge of health plan operations, products, and regulations.
• Strong analytical skills and proficiency in data analysis tools (e.g., Excel, SQL)
• Experience collaborating with internal/external actuarial services and sales departments

Expectations and Standards

• Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
• Promote Avera’s values of compassion, hospitality, and stewardship.
• Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
• Maintain confidentiality.
• Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.

Benefits You Need & Then Some

Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future.

• PTO front-loaded for eligible hires

• Free health insurance options, for full-time single coverage on Avera High Deductible Health Plan

• Up to 5% employer matching contribution for retirement

• Career development guided by hands-on training and mentorship

Applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org .