Description

Note: Work location is remote (e.g. home address), per Kaiser Permanente-s Authorized States Policy - Employees may be required to travel to a Kaiser Permanente or customer sites. Residency required in the primary location:
500 NE Multnomah St., Portland, Oregon 97232

This position may have visibility in all Kaiser Permanente Authorized locations. *Compensation may differ based on the market.

Job Summary:

Evaluates highly complex data to understand premium, claim, exposure, and population. Coordinating the identification and resolution of data insights/irregularities. Setting the direction for creating/using/documenting models, tools, and assumptions that support business strategy analysis and risk management. Making recommendations to improve the implementation of state-of-the-art quality and process improvement efforts. Works in support of department initiatives, program, and enterprise goals. Assesses risk of accounts. Leverages expert knowledge of the external business environment. Presents renewal recommendations to clients/organization. Collaborates internally to develop case/investment strategies. Owns the development of rates and account plans that mitigate risk. Shapes the strategic direction for rate negotiations with external parties. Helps highly complex customers understand underwriting approach. Addresses highly complex data needs and requests. Builds relationships and influences outcomes with customers and channel partners. Works with internal partners to bring financial solutions to highly complex customers. Provides self/peer review of highly complex cases. Maintains compliance with relevant policies, guidelines, and procedures.

Essential Responsibilities:

• Promotes learning in others by communicating information and providing advice to drive projects forward; builds relationships with cross-functional stakeholders. Listens, responds to, seeks, and addresses performance feedback; provides actionable feedback to others, including upward feedback to leadership and mentors junior team members. Practices self-leadership; creates and executes plans to capitalize on strengths and improve opportunity areas; influences team members within assigned team or unit. Adapts to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback. Models team collaboration within and across teams.
• Conducts or oversees business-specific projects by applying deep expertise in subject area; promotes adherence to all procedures and policies. Partners internally and externally to make effective business decisions; determines and carries out processes and methodologies; solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Develops work plans to meet business priorities and deadlines; coordinates and delegates resources to accomplish organizational goals. Recognizes and capitalizes on improvement opportunities; evaluates recommendations made; influences the completion of project tasks by others.
• Analyzes and reports on data by: evaluating highly complex data to understand premium, claim, exposure, and inform understanding of population risk; applying expert knowledge to evaluate credibility, utilization, and risk based on population size and prior predictive behavior of the pool/account; coordinating and planning the identification and resolution of actionable insights and data irregularities; setting the future direction for creating and using models (e.g., rate models and benefit pricing tools) and data analytics tools that support the analysis of business strategy and financial/underwriting risk management; and consistently documenting models, tools, assumptions, and data elements for highly complex accounts, as required.
• Completes case and underwriting work by: processing renewal activities (e.g., running reports, re-quotes, investments, sold rates) for customers and/or book of business and guiding others; in collaboration with internal departments, owning the development of rates that appropriately mitigate risk for the organization and optimize sustainable membership growth; ensuring effective partnerships with Sales and Account Management to an account plan that addresses threats and opportunities to ensure attainment of goals; shaping the strategic direction for rate negotiations with external parties (e.g., brokers, consultants, and customers); and representing Underwriting in partnership with internal and external partners to co-create effective consultative solutions (e.g., case strategy, investment strategy, benefits strategy).
• Contributes to case review and preparation by: independently conducting account risk assessment using competitive analyses, broker behavior, network cost profiles, legislative and regulatory impacts, revenue requirements, and contributions, with guidance as requested, especially when working on highly complex cases; utilizing data and standardized tools, and developing supplemental tools and applications for highly complex cases, to present underwriting and renewal actions and recommendations (e.g., rate drivers, potential risk, glide path, membership impact, projections for future) to clients and/or the organization, with guidance as requested; maintaining, applying, and expanding expert knowledge of the external business environment and how it applies to the line of business and/or region; and collaborating with Sales and Account Management to develop case/investment strategies and recommendations with appropriate documentation.
• Engages with the external market by: helping highly complex market/customers understand the underwriting approach (e.g., rating methodology, rate drivers, reporting capabilities, and uniqueness from fee for service carriers); addressing highly complex data needs and requests reactively and proactively, as they arise; building relationships and influencing outcomes with customers and channel partners that enable them to understand KPs value; and collaborating with account management and sales partners to bring strategic, financial solutions to customers, communicate product capabilities, explain funding arrangements, and negotiate conditions of offering and pricing within the limits of their authority for highly complex accounts.
• Contributes to goals, initiatives, and program development efforts by: making recommendations to address issues in implementation of innovative, state-of-the-art quality and process improvement efforts; and executing their work in support of department initiatives, program goals, and enterprise goals.
• Ensures compliance of Underwriting work by: providing self/peer review of highly complex cases, as required, to ensure accuracy and appropriateness of quotes and incorporating feedback from others; appropriately obtaining and documenting case approvals and any policy exceptions and investments; making investment decisions within their authority and escalating to the appropriate level, as needed; and maintaining awareness of and compliance with all relevant policies, guidelines, and procedures, applying them to their own work.

Knowledge, Skills and Abilities: (Core)

• Ambiguity/Uncertainty Management
• Attention to Detail
• Business Knowledge
• Communication
• Critical Thinking
• Cross-Group Collaboration
• Decision Making
• Dependability
• Diversity, Equity, and Inclusion Support
• Drives Results
• Facilitation Skills
• Health Care Industry
• Influencing Others
• Integrity
• Learning Agility
• Organizational Savvy
• Problem Solving
• Short- and Long-term Learning & Recall
• Teamwork
• Topic-Specific Communication

Knowledge, Skills and Abilities: (Functional)

• Actuarial Techniques and Principles
• Applied Data Analysis
• Business Acumen
• Claim Analysis
• Data Quality
• Financial Modeling
• Insurance
• Interpersonal Skills
• Microsoft Office
• Negotiation
• Organizational Skills
• Presentation Skills

Minimum Qualifications:

• Bachelors degree in a related field AND minimum six (6) years of experience in Underwriting, Marketplace Evaluations, Financial Analysis, or a related field OR Minimum nine (9) years of experience in Underwriting, Marketplace Evaluations, Financial Analysis, or a related field.

Preferred Qualifications:


Primary Location: Oregon,Portland,Kaiser Permanente Building
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri
Working Hours Start: 08:00 AM
Working Hours End: 05:00 PM
Job Schedule: Full-time
Job Type: Standard Worker Location: Remote
Employee Status: Regular
Employee Group/Union Affiliation: NUE-PO-01|NUE|Non Union Employee
Job Level: Individual Contributor
Department: Po/Ho Corp - HP PROD MGMT-NATL ACCTS Pricng - 7016
Pay Range: $116900 - $151250 / year Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location. Travel: Yes, 5 % of the Time Remote: Work location is the remote workplace (from home) within KP authorized states. Worker location must align with Kaiser Permanente's Authorized States policy. Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.
Requisition #: 1433315

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