Manager of Insurance Product & Pricing

Description

• Single or Family Health Insurance with discounted premium rates for wellness program participation.
• 401k with immediate matching (50% on the dollar up to 7% of pay) + additional annual Profit Sharing
• Flexible Paid Time Off Program (29 days off/year)
• Medical and Dependent Care Flex Spending Accounts
• Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc. 

•  Underwriting Management: Oversee the evaluation of risk for potential and renewal business, ensuring underwriting decisions align with financial goals and company risk appetite.
• Provider Contracting: Lead contract negotiations, drafting, and implementation with healthcare providers to establish reimbursement rates and network structures.
• Product Oversight: Manage product design and specifications to ensure alignment with regulatory requirements, evolving market trends, and financial optimization objectives, including pricing strategy, benefit structure, and competitive positioning.
• Compliance & Auditing: Ensure compliance with state statutes, industry regulations, and internal underwriting guidelines. Manage rate filings and network adequacy requirements.
• Strategy & Profitability: Analyze claims data to identify trends, improve underwriting models, and implement pricing strategies. Develop budget and investigate variances.
• Leadership & Strategy: Manage selection, training, development, performance evaluations, and performance issues of assigned staff. 
• Complete all other assigned projects and duties.

Physical Aspects: Reaching- Extending hand(s) and arm(s) in any direction. Lifting- Raising objects from a lower to a higher position or moving objects horizontally from position-to-position. This factor is important if it occurs to a considerable degree and requires the substantial use of the upper extremities and back muscles. Fingering- Picking, pinching, typing or otherwise working, primarily with fingers rather than with the whole hand or arm as in handling. Grasping- Applying pressure to an object with the fingers and palm. Talking- Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers accurately, loudly or quickly. Hearing- Perceiving the nature of sound with or without correction. Ability to receive detailed information through oral communication and to make fine discriminations in sound, such as when making fine adjustments on machined parts. Vision- 20 / 40 or better in the best eye with or without correction. Repetitive Motions- Substantial movements (motions) of the wrists, hands and/or fingers. Sedentary Work- Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met. Environmental Conditions:None- The worker is not substantially exposed to adverse environmental conditions (such as in typical office or administrative work).

Medical Associates Clinic & Health Plans is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, pregnancy, age, national origin, marital status, parental status, disability, veteran status, or other distinguishing characteristics of diversity and inclusion, or any other protected status.Please view Equal Employment Opportunity Posters provided by OFCCP https://www.eeoc.gov/poster