You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Company Information

Our client company operates within the commercial health insurance sector, focusing on innovative funding solutions for employer groups.

Job Summary

Our client is seeking an Underwriter to join their team. This role encompasses both intermediate and senior level responsibilities related to evaluating, pricing, and structuring level-funded health insurance risks for employer groups, typically ranging from 51 to 500+ lives. The Underwriter will manage complex group claims data, utilize predictive modeling, handle stop-loss mechanisms, and manage intermediary/broker relations. At a senior level, the role involves acting as a technical expert for high-exposure accounts, managing escalated negotiations, and shaping underwriting frameworks for alternative funding products, including technical mentorship and collaboration with leadership for sustainable market growth.

Key Responsibilities

• Evaluate financial and clinical risk factors for commercial groups using historical claims data, high-cost claimant reports, corporate demographics, and industry profiles.
• Calculate monthly level premium rates by precisely allocating components for expected claims funds, specific and aggregate stop-loss insurance premiums, administration/TPA fees, and network access costs.
• Review large-group claims utilization metrics, prescription drug spend, and health risk assessments to forecast future liabilities and determine defensible renewal strategies.
• Articulate complex level-funded financial models, surplus potential mechanisms, and risk assessments to regional brokers, sales representatives, and prospective client executives.
• Apply underwriting guidelines, corporate risk thresholds, and federal/state regulatory standards (including ERISA and HIPAA frameworks) to all case evaluations.
• Monitor block performance and evaluate mid-term group utilization trends to flag high-risk cases ahead of annual renewal cycles.
• Underwrite, negotiate, and approve high-exposure large-group cases requiring customized benefit designs, unique stop-loss attachments, or non-standard pharmacy/carve-out structures.
• Optimize complex tiering and cross-subsidization structures for level-funded groups to ensure maximum alignment between expected claim reserves and aggregate stop-loss limits.
• Partner closely with executive sales leadership and top-tier regional brokerage houses to defend pricing models, close complex new business RFPs, and retain critical large group renewals.
• Conduct macro-level analyses of the level-funded block to identify underlying loss ratio trends, proposing guideline adjustments or product tweaks to Actuarial and Product Development teams.
• Serve as a referral authority for cases exceeding intermediate underwriting limits. Review and sign off on peer assessments while providing technical guidance and mentoring to junior and intermediate staff.
• Serve as a subject matter expert on federal and regional health care regulations governing self-insured and alternative funded programs, ensuring portfolio-wide compliance.

Qualifications

• Minimum 2 years of experience in group level funded underwriting.
• At least 1 year of experience specifically in large group underwriting.

Skills

• Risk evaluation and pricing for health insurance.
• Level-funded structuring and financial modeling.
• Proficiency in data analysis and predictive modeling.
• Strong collaboration and negotiation skills with brokers and clients.
• In-depth knowledge of compliance and regulatory standards (ERISA, HIPAA).
• Effective portfolio management and trend analysis.
• Strategic financial engineering and optimization.
• Mentorship and ability to provide technical guidance.

Additional Requirements

This role requires a standard work week of 40 hours, Monday through Friday. The position offers a flexible work arrangement, including remote options, with potential for a hybrid schedule for candidates within a commutable distance to a company office.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

Medix is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

Any required state or Joint Commission training is compensated at the state or local minimum wage rate.

^*As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients