Note: The job is a remote job and is open to candidates in USA. Blue Cross and Blue Shield of Kansas is looking to add to their Underwriting team with a new opportunity for an Underwriting Quality and Tools Analyst. This role focuses on ensuring the accuracy and efficiency of underwriting processes and involves responsibilities such as quality assurance, actuarial support, and process optimization.

Responsibilities

• 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.

Skills

• 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.
• Strong analytical and problem-solving skills to assess underwriting data, quality trends, actuarial trends, risk factors, and process inefficiencies.
• Expertise in quality assurance methodologies and underwriting rating tools.
• Ability to develop and deliver technical training programs and create comprehensive documentation for underwriting processes.
• Knowledge of actuarial and underwriting principles, rating methodologies, and health insurance regulatory compliance.
• Strong organizational skills with the ability to manage multiple tasks and deadlines efficiently.
• Proficiency in reporting, database management, and underwriting system tools.
• Excellent communication and collaboration skills to work effectively with actuarial and underwriting teams, auditors, and regulatory bodies.
• Experience with rate filings (SERFF) and regulatory compliance reporting.
• Experience in reporting, process improvement, and automation of underwriting workflows preferred.
• Background in regulatory compliance, rating factors, and underwriting system administration is a plus.

Benefits

• Incentive pay program (EPIP)
• Health/Vision/Dental insurance
• 6 weeks paid parental leave for new mothers and fathers
• Fertility/Adoption assistance
• 2 weeks paid caregiver leave
• 5% 401(k) plan matching
• Tuition reimbursement
• Health & fitness benefits, discounts and resources

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