Individual Underwriter II

Position Description Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more. At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.” The position is responsible for performing complex analyses related to group renewals, prospect quotes, and customer settlements. This role independently develops rate recommendations, evaluates underwriting risk for medically underwritten Medicare supplement applications, and ensures consistency with Capital Blue Cross underwriting guidelines, policies, and procedures. The incumbent serves as a key resource within the unit, supporting a variety of financial and analytical functions with limited direction. Advanced mathematical, financial, and analytical skills are applied to evaluate data, model outcomes, and formulate well-supported recommendations that achieve business and financial objectives. Strong communication and consultative skills are used to collaborate with internal partners and provide guidance on underwriting and rate decisions. Responsibilities and Qualifications Independently review and analyze renewals and rate exception requests; develop and present rate recommendations to management for Review complex rate exception requests for prospect groups; evaluate data trends, market competitiveness, and risk to support pricing Serve as a key contact for Sales, Sales Management, and Underwriting Management, providing consultative support and data-driven Interpret and review financial contract language to ensure accuracy and compliance prior to settlement Perform detailed settlement reviews; identify anomalies, conduct root cause analysis, and document findings and corrective Review and assess complex or borderline Medicare supplement applications; apply advanced judgment to risk rating Mentor or assist less experienced analysts in data interpretation, underwriting practices, and analysis Respond to escalated inquiries concerning underwriting or rate decisions, providing clear rationale and

Skills:

• Strong analytical and quantitative skills with demonstrated ability to interpret complex medical, enrollment, and claims data.
• Proficiency in applying financial modeling and theoretical structures to assess and forecast financial implications.
• Strong written and verbal communication skills, including the ability to explain technical analyses to leadership and non-technical stakeholders.
• Ability to work independently, prioritize multiple assignments, and exercise sound judgment in decision-making.

Knowledge:

• Advanced understanding of financial and accounting concepts, underwriting principles, and risk assessment methodologies.
• Knowledge of group insurance products, particularly Medicare Supplement, and familiarity with regulatory requirements.
• Proficiency in Microsoft Office Suite; experience with data analytics tools or databases preferred.

Experience:

• Typically requires 3-5 years of experience in underwriting, financial analysis, or a related operational role.

Education and Certifications:

• Bachelor’s degree in business, Finance, Mathematics, or a related field preferred; equivalent combination of education and experience will be considered.

Physical Demands:

• While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.
• The employee must be able to work over 40 hours per week.
• The employee must occasionally lift and/or move up to 5 pounds.

About Us We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of im