Job Description

Define and construct a new age underwriting workflow which is more customer centric, and tech enabled Application of clinical expertise in decision making Evaluation of prevail underwriting practices & market comparison & analysis of data to help revise UW guidelines Alignment with cross functional key stakeholders Owner of process adherence and managing health advisor as well as other partners involved in sourcing. Mapping & maintaining SLA (Service Level Agreement) & TATs (Turn Around Times). Define and own underwriting system & rules integrated with sourcing interfaces. Key opinion holder for cross functional alignment & projects. Gathers and prepares preliminary clinical and medical analysis based on information from historical claims utilization data. Develops/prepares reports and assists in the development of new/revised policies and guidelines based on utilization and clinical trends. Prepare clinical and medical recommendations based on data summaries, trend analysis, financial analysis, and business analysis. 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 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. Prepares clinical and medical analysis based on employer group utilization and claims data and coordinates with the appropriate wellness, medical and care management specialty teams to address these identified risks Assist and provides clinical and medical analysis on Actuarial research and studies and product development initiatives. Prepares and may do presentations. Participates in cross-functional teams to develop new/enhanced systems / processes / programs / policies to support business needs. Performs other duties that may be assigned from time to time. People Management: Team management; work appraisals and growth of team; develop training, Coaching & Mentoring program; Conflict resolution; Attrition management. You could be the right candidate if you Qualification: - Doctor (MBBS preferred /BAMS/BHMS/BDS) Should be a decisive & creative individual. Should be able to make quick decisions and have good judgment and analytical skills Have an excellent verbal and written communication skills and strong negotiation skills. Always open to embracing change and be able to manage it Have 10-15 years experience of medical underwriting in health insurance This could be the gig for you if you Are passionate about consumer behavior and culture; enjoy spending time with customers to understand what they really want. Have an attentive ear listen to new ideas. Thrive in environments that celebrate co-creation and collaboration Have strong clinical knowledge and clinical decision-making skills Have built best in class processes from a scratch Are passionate about leveraging digital tools to transform customer experience Like to work in a culture where everyone can see what others are doing Take help from others when stuck and encourage others when there are setbacks Take full responsibility for your team s contribution output while thinking wing to wing across the organization; to solve for the customer What can make you extra special It s great if you have already read books like Blue Ocean strategy, Measure what matters & Zero to One. Before you saw them mentioned here You have real stories to tell about how your team and you challenged convention and took the path less travelled. We are keen to listen to your story; doesn t matter if you tell these stories with a sigh or with excitement. We respect both versions. Truly.