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Sr Underwriting CQI Specialist

Company: Health Care Service Corporation
Location: Downers Grove
Posted on: September 20, 2022

Job Description:

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. Sr Underwriting CQI Specialist - 9/7/22 Full-Time Regular IL - Chicago, IL - Downers Grove, TX - Richardson Employees in this position collaborate with leadership and subject matter experts within and outside the Enterprise Group Underwriting organization to support the organization's change readiness and continuous quality improvement activities.Employees in these hybrid roles may be engaged in one or more of the following core functions, to support fluctuating business needs:

  • Information Triage
  • Data Analysis
  • Management Reporting
  • Business Requirements
  • System Testing
  • Audits (Case/Target; Internal/External)
  • Facilitating Enterprise Process Improvement & Consistency
  • Identifying & Working to Close KST Gaps in Staff & Management
  • Lead or Participate in Divisional & Corporate Projects Required Job Qualifications:Applicable to this position:
    • Verbal and written Communications: clear, concise, correct grammar, accurate word choice, audience specific language, and appropriate tone.
    • Experience and ability to establish and maintain business relationships with a network of internal and/or external customers, senior management, subject matter experts.
    • Work management skills to include managing multiple major assignments simultaneously.
    • Maintain complete confidentiality of company business.
    • PC experience with Microsoft Word, Excel, PowerPoint and other/Underwriting systems relevant to focus of position.Plus one of the following requirements:Job level application based knowledge of one or more specified subject areas supported by the department (as designated by the hiring manager):
      • 1 year experience performing Underwriting systems testing.
      • 4 years experience in a group health underwriting area, including rating group health insurance proposals/new business, renewals, and revisions for fully insured and alternate funded groups.
      • 4 years experience in creating and producing management reports.ORExperience and abilities in three or more of the following areas (as designated by the hiring manager):
        • 2 years group health industry experience in a functional area relating to underwriting, sales/account management, benefits, claims, and/or customer service.
        • Project management skills to include managing and/or participating in multiple projects simultaneously and achieving project goals
        • Analytical and problem-solving skills.
        • Experience and skills analyzing and synthesizing data.
        • Designing and delivering presentations or training sessions/courses
        • Creation of documentation, job aids and process documentsPreferred Job Qualifications:
          • In depth knowledge of insurance or health care or underwriting concepts, theory, and application.
          • Experience in group health underwriting
          • Familiarity with Large Groups (151+) or Major/National Accounts segment(s)**The primary focus areas for the open QA position include performing Large Group/National Accounts case audits, acting as Ent Grp UW liaison for internal/external/MAR audits, and providing CQI team input on Settlement System enhancements. Prior UW system testing/management reporting experience are NOT necessary for this position.**Familiarity with Large Groups (151+) or Major/National Accounts segment(s)**We encourage people of all backgrounds and experiences to apply. -Even if you don't think you are a perfect fit, apply anyway - you might have qualifications we haven't even thought of yet. -**Position is remote or telecommuter but candidate must be near Downer's Grove, Chicago or Richardson offices. -*CA#LI-LK1HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.Requirements: Expertise Underwriting Job Type Full-Time Regular Location IL - Downers Grove, TX - Richardson, IL - Chicago HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants.If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "my account" and click on "View your job submissions".

Keywords: Health Care Service Corporation, Downers Grove , Sr Underwriting CQI Specialist, Other , Downers Grove, Illinois

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