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Facility: Health Plan
City San Diego
Department
Job Status
Regular
Shift
Day
FTE
1
Shift Start Time
Shift End Time
H.S. Diploma or Equivalent
Hours
Shift Start Time:
Variable
Shift End Time:
Variable
Additional Shift Information:
Weekend Requirements:
No Weekends
On-Call Required:
No
Hourly Pay Range (Minimum - Midpoint - Maximum):
$24.091 - $30.113 - $36.136
The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.
What You Will Do
This position supports the underwriting process by using established criteria to price, process and certify prospective and renewing small group employers. The position provides administrative assistance for all departmental functions.
Required Qualifications
Preferred Qualifications
Essential Functions
Collaborates with commercial salesWorks closely with the Commercial Sales Department to provide pricing information timely and in accordance with Plan and regulatory requirements to support the overall sales effort.Collaborates with Commercial Sales Department to provide education on pricing and pricing support for enhanced presentation to Plan customers.
Internal and external customer serviceProvides prompt, accurate and excellent services to internal and external customers.Develops solid professional working relationships with various internal departments and units and, as required, vendors, providers, employers, brokers and/or other customers.
Monthly recertification schedulesPrepares recertification schedule for renewing business on a monthly basis.Processes recertification documentation within 5 days of receipt to ensure renewing business is in compliance with Plan and regulatory small group guidelines.Documents receipt and recertification status for all small groups and notifies Sales department of final acceptance/declination in accordance with Underwriting policies and procedures.
Participates in other duties as assignedParticipates in special projects and other duties as assigned; These may include, but are not limited to, work groups, proposals, audits and back-up support for other departments.
RenewalsPrepares renewal schedule and renewal rates 60 days in advance of renewal date for existing small groups on a monthly basis.Applies Plan approved small group underwriting guidelines in a consistent manner.Ensures compliance with regulatory requirements.Assesses and adjusts renewals to meet financial objectives based upon existing demographics and established Plan targets, prior to management review and final management approval.Distributes renewal group information to internal departments consistent with Underwriting policies and procedures.
Request for quotes processingPrepares Requests for Quote (RFQ) for prospective clients within 2 days of Underwriting receipt date.Uses filed Plan rates and applies Plan small group underwriting guidelines in a consistent manner.
Sold employer group submissions processingProcesses sold Employer Group submissions within 2 days of Underwriting receipt date.Validates business certification in accordance with Plan and regulatory small group underwriting guidelines.Finalizes sold rates based upon final census.Distributes sold business information to internal departments upon approval of client acceptance.
Knowledge, Skills, and Abilities
Knowledge of state and federal regulations including California Health & Safety Code Section 1357.
Ability to function independently and make sound decisions based upon thorough investigation of available information.
Excellent knowledge of Microsoft Office software, including Excel, Word and Access.
Ability to handle complex tasks. Strong interpersonal skills.
Excellent oral and written communication skills.
Legal and medical terminology preferred.
Ability to manage several concurrent projects, while prioritizing accordingly to meet relevant timelines.
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class