Synergy Wellcare Medicaid Limited is seeking a highly experienced, strategic, and results-oriented professional to join our team as an Underwriter.
The successful candidate will be responsible for underwriting health insurance plans, assessing risks, developing appropriate pricing and benefit structures, and supporting the organization's profitability and business growth.
Key Responsibilities
Underwriting & Risk Management
Lead underwriting for individual, group, SME, and corporate HMO plans.
Assess health and financial risks to determine appropriate pricing, benefits, and exclusions.
Develop, review, and recommend underwriting policies and premium structures.
Analyze claims trends, utilization patterns, and provider costs.
Design customized health plans aligned with client needs and profitability objectives.
Review existing health plans and recommend adjustments based on claims experience and utilization.
Monitor underwriting performance and identify potential areas of risk and loss.
Evaluate client risk profiles and recommend appropriate premium rates and benefit structures.
Work closely with the Business Development, Claims, Provider Management, Finance, and Operations teams to ensure commercially viable health plans.
Support the preparation of quotations and proposals for prospective corporate and group clients.
Participate in negotiations with clients and other relevant stakeholders on pricing, benefits, and terms of coverage.
Educational Qualifications
Bachelor's Degree in Insurance, Actuarial Science, Business Administration, or a related discipline.
Relevant professional certification in Insurance, Health Insurance, or a related field will be an added advantage.
Experience Requirements
Minimum of 3 years cognate experience in an HMO or Health Insurance organization.
Proven experience in underwriting, pricing, risk assessment, and/or business development.
Strong understanding of HMO benefit structures, pricing models, provider tariffs, and claims utilization.
Experience in handling corporate, group, SME, or individual health insurance plans will be an added advantage.
Core Competencies & Skills
Strong analytical and financial evaluation skills.
Excellent negotiation, sales, and relationship-management abilities.
Strong understanding of HMO operations and health insurance products.
Commercially driven with sound risk-management judgment.
Ability to analyze claims and utilization data to support underwriting decisions.
Ability to work independently and make sound business decisions.
Excellent communication and interpersonal skills.
Strong attention to detail.
High level of professionalism, confidentiality, and integrity.