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- 42 jobs
  • Mail Clerk I (Onsite - Day Shift)

    Excellus Health Plan 4.7company rating

    Remote or Rochester, NY job

    This position is onsite/in-person at our Court St. office in Rochester, NYShift: Monday - Friday 8:30AM - 5PM. Under general supervision, this role is responsible for sorting and delivering incoming mail, managing outgoing mail, and assisting with other administrative tasks as needed. The position may perform additional functions depending on region. Essential Accountabilities: Level I - All Regions • Sorts all incoming mail and packages by department and delivers on a timely basis. May scan incoming mail to recipients/departments. • Obtains signatures for verification of receipt of all special delivery packages (e.g., UPS, FedEx). • Using automated equipment, folds, inserts, and seals for delivery all monthly bills, notices, etc. • Processes all outgoing mail through automated mailing equipment and meters. • Performs manual insertion and metering as needed. • Performs manual presort of books and letter jobs. • Prepares non-metered mail for processing by third party vendors. • Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs. • Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. • Regular and reliable attendance is expected and required. • Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) Additional Functions Specific to Buffalo • Completes mail merge tasks including printing, inserting and mailing of special mailings. Assists on special projects to include kitting of envelopes. • Monitors postage business reply and all postage accounts to ensure proper dollar funds are available. • Monitors USPS accounts on Business Customer Gateway. • Codes, copies, and files all incoming vendor invoices and ensures they are sent to manager. • Receives all purchase order-related deliveries into Workday. Additional Functions Specific to Utica • Verifies data from incoming surveys. • Receives all purchase order-related deliveries into Workday. • Maintains floor copiers, delivers supplies, cleans and addresses basic break/fix issues. • Assists facilities team with moves and room setups. • May assist with building service needs in the absence of Facilities team members. Additional Functions Specific to Rochester • Scans and verifies data from incoming surveys. • Scans and archives inbound health plan member applications. • Supports the role of Quality Specialist. Additional Functions Specific to Syracuse • Receives all purchase order-related deliveries into Workday. • Coordinates inbound and outbound shipments for retrieval of employee equipment. • Maintains floor copiers, delivers supplies, cleans and addresses basic break/fix issues. Minimum Qualifications: NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities. All Levels • High school education or equivalent (GED/Vocational experience) with mail room/data processing experience preferred. • Good visual acuity and manual dexterity and be able to stand, sit and walk for prolonged periods of time. • Computer literate in Microsoft Office, familiarity with equipment driven programs. Excellent typing skills. • Good communication and interpersonal skills; ability to professionally interact with all levels of employees, up to senior management. • Superior attention to detail. • Ability to work in group as well as individual settings. Level II (in addition to Level I Qualifications) Buffalo/Syracuse/Utica • Familiarity with PO receiving tools within Workday. Syracuse/Utica • Familiarity with multi-function device (print/scan/copy) maintenance. Rochester • Familiarity with Kodak scanning hardware and software. Physical Requirements: • This is a physically active role requiring daily actions including, but not limited to: walking, standing, bending over, crouching, kneeling, reaching overhead, pushing/pulling items, and repetitive motion. • Ability to lift, carry, push, or pull up to 50 pounds. • Ability to read, hear, understand, and clearly communicate instructions/directions. • Manual dexterity including fine finger motion required. ************ In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer Compensation Range(s): Minimum: $18/hr - Maximum: $21.60/hr The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
    $18-21.6 hourly Auto-Apply 13d ago
  • Medicare Part D Formulary Manager (Pharmacist)

    Excellus BCBS 4.7company rating

    Remote or Binghamton, NY job

    This pharmacist clinician is a program manager, who is responsible for all Medicare Part D formulary creation and submissions, which includes utilization management criteria development for the current and upcoming contract years. This individual creates and executes the Medicare Part D formulary, delivering value and quality to the Plan's Part D enrollees, while ensuring the longevity of the Plan's Part D program. Essential Accountabilities: Develops and maintains the Part D formulary in collaboration with strategic business partners, which include trade relations, finance, and sales to maximize savings, ensure quality, and minimize member disruption, while incorporating all CMS Part D guidance Manages all CMS Part D Formulary requirements to ensure deadlines are met. Works in conjunction with the Pharmacy Benefit Manager (PBM) and Formulary Management software vendor to execute on all formulary-related tasks. Collaborates with cross-functional management teams within the organization to align and prioritize Medicare objectives across the organization to ensure success within the framework of the Medicare STARS ranking system and deliver value to enrollees. Creates and operationalizes Medicare Part D criteria for all utilization management requirements in alignment with the Utilization Management Team. Obtains endorsement of the Medicare Part D formulary program elements from the Pharmacy and Therapeutics Committee. Oversees the production of CMS formulary model materials in partnership with Medicare Sales and Marketing. Works in conjunction with the outside vendor as needed to complete all formulary-related tasks. Supports and educates inter-departmental staff (clinicians, customer care, sales) and external customers (members, brokers) with respect to Part D formulary, utilization management edits, and CMS Part D program guidance, as appropriate. Reviews, formulates, and executes corrective action plans in conjunction with Medicare Compliance for all formulary-based findings. Supports and acts as subject matter expert for CMS formulary-based audits. Acts as a subject matter expert for clinical strategy initiatives designed to improve quality and affordability for Medicare beneficiaries. Contributes to clinical strategy initiatives within the Pharmacy Department and across the enterprise, which serve to improve quality and affordability for Medicare beneficiaries. Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct and leading to the Lifetime Way values and beliefs. Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Regular and reliable attendance is expected and required. Performs other functions as assigned by management. Minimum Qualifications: Unrestricted NYS Licensed Pharmacist. Pharm.D. In lieu of a Pharm.D., a Bachelors in Pharmacy is required with a minimum of three (3) years' experience in a managed care setting. Experience in Medicare Part D is strongly preferred. Expertise and background with Federal and state regulatory agencies (CMS, DOH, DFS, etc.) and/or accreditation agencies (NCQA, BCBSA) is preferred, but not required. Proficiency in Microsoft Excel preferred. Ability to articulate complex information in a manner that can be understood by various internal and external target audiences. Possesses the confidence to think and act differently. Demonstrates ability to thoughtfully challenge the status quo related to clinical and operational strategies and processes. Physical Requirements: Ability to work prolonged periods sitting and/or standing at a workstation and working on a computer. Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time. Ability to work in a home office for continuous periods of time for business continuity. Ability to travel across the Health Plan service region for meetings and/or trainings as needed. Ability to lift, carry, push, or pull 15 pounds or less. Manual dexterity including fine finger motion required. Repetitive motion required. The ability to hear, understand, and speak clearly while using a phone, with or without a headset. ************ In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer Compensation Range(s): Min: $98,297 - Max: $176,935 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
    $98.3k-176.9k yearly Auto-Apply 19d ago
  • Property Claims Assistant Manager

    EMC Insurance Group 4.6company rating

    Remote job

    At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together. **Ideal candidate would be located within either the Central or Eastern time zone** Essential Functions: Provides direct managerial oversight to property claims team, including cyber claims. Reviews all claims files assigned to team and analyzes files for necessary facts, including reaching out to appropriate parties to gather any missing information. Assigns claims to the appropriate handler with the right skills and experience based on review of the file. Guides team through complex questions of coverage, compensability, liability, claim value and strategy for resolution. Assigns or assists in the selection of counsel and monitors litigated matters. Ensures that timely, adequate reserves have been established on claim files in compliance with the company's reserve guidelines and methodology. Ensures adjusters are handling claims in accordance with company's claims handling best practices and claims philosophy. Properly identifies files appropriate for claims committee or assignment to Large Loss, Coverage Counsel or Subrogation. Ensures proper reserves and authorizes claim payments within authority. Controls claim and loss costs and adjustment expenses. Routinely meets with team members to monitor business decisions made to ensure compliance with authority levels, good faith claim handling, and regulatory requirements. Collaborates with team members to establish performance goals and monitors status. Conducts performance reviews and provides coaching. Interviews, hires, and recommends salary adjustments for team members. Resolves disciplinary issues, reviews results, actions plans, and progress. Develops team expertise and assists with succession planning, including identifying talent and implementing development plans for critical positions. Supports diversity, equity, and inclusion initiatives. Fosters an innovative culture, including supporting new ideas and providing guidance on potential changes. Develops and fosters excellent customer relations as it relates to property claims. Monitors customer service metrics and ensures that customer experience levels are being met. Develops and markets the claim brand and culture among EMC teams, and prospects in the industry. Education & Experience Bachelor's degree or equivalent relevant experience Eight years of experience in property claims adjusting or related experience, including experience with large and complex claims Attainment of all applicable state licenses as required Prior leadership experience Insurance designations, such as INS, AIC, and CPCU preferred Knowledge, Skills & Abilities: Excellent understanding and application of property loss claims techniques and a current knowledge of property estimation practices and property claims techniques Advanced knowledge of insurance terms and coverages in commercial lines Strong leadership qualities with the ability to motivate staff Excellent knowledge of computers and claims systems Excellent organizational, written and verbal communication skills Excellent ability to gather and analyze a variety of data points to appropriately triage claims handling Advanced investigative and problem-solving abilities Occasional travel required; a valid driver's license with an acceptable motor vehicle report per company standards required if driving The hiring salary range for this position will vary based on geographic location, falling within either of the following: $97,889 - $134,921 or $107,944 - $148,758 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit *********************** Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.
    $43k-75k yearly est. Auto-Apply 27d ago
  • Territory Management Consultant

    EMC Insurance Group Inc. 4.6company rating

    Remote or North Carolina job

    At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together. This position can be performed remotely for candidates who reside in North Carolina or South Carolina Essential Functions: * Oversees an assigned territory with broad and challenging agency partners driving profitable premium growth to achieve financial and operational goals * Creates, implements and executes territory and agency strategies to achieve short term and long term goals utilizing all company programs, tools and resources in collaboration with internal business partners * Leads a collaborative, proactive approach with underwriters to drive profitable premium growth within a territory through directing sales pipeline activity, identifying account leads and prospects, pre-qualifying business, and selling quotes and EMC to agents * Creates demand by marketing EMC as a leader in the market. Enables agents/producers to maximize the flow of desirable business to meet or exceed goals * Owns the business development process within assigned market area with heavy emphasis on developing a pipeline of profitable new business and renewal retention * Continually identifies and evaluates prospects for new agencies within the territory. Surveys prospective agencies and obtains completed agency applications * Identifies new agencies and effectively onboards the agency. Discusses company and agency responsibilities and establishes a business plan for the agency. * Leads training of agencies on EMC products and services, rate levels, underwriting eligibility, sales techniques, EMC and agency technology, and other administrative processes * Researches EMC's competitive position in the marketplace, proactively providing competitive intelligence to the branch and corporate offices as appropriate. Performs surveys of competitor products and services, rate levels, producer compensation and incentives, and marketing efforts * Evaluates the impact of market conditions and representation by territory and recommends changes in agency representation within an assigned territory. * Determines areas of the branch territory to further develop or expand market presence and leads recommendation discussions with appropriate branch team members * Builds and cultivates complex agency partnerships in person with agency ownership, management and frontline team members * Creates, drives, and manages strong producer relationships through high visibility, clear knowledge of company strategy and joint sales planning * Drives the acquisition and evaluates complex new business accounts with agents through properly conveying branch and underwriting risk appetite, discussing leads and prospects, and pre-qualifying submissions and evaluating risks. Collaborates with underwriters to secure the acquisition of desirable individual accounts * Establishes position as a subject matter expert while delivering product, underwriting philosophy, appetite and system training, and support retention and new business development to increase depth and maximize agency revenue * Partners with existing and prospective independent agencies to develop a strategy to drive profitable business and sources of new business * Leads, influences and supports internal business partners to identify and capitalize on opportunities, resolve problems, share key competitor and industry intel and provide a voice for our agent/customer * Communicates with branch team about complex agency relationships and proactively coordinates actions to address potential issues, involving other departments as appropriate * Serves as a consultant to the agency and branch to articulate and explain coverages, premiums and claim decisions, involving other departments as appropriate * Leads and organizes various functions to promote EMC and/or represents EMC at special events, such as agency sales meetings, agency trade association meetings, etc. * Builds and executes an effective agency management sales plan with broad and challenging agencies to achieve maximum production and profit goals in assigned territory * Leads assigned geographical territory and agency management processes (e.g. agency prospecting, business planning, engagement, training, compensation, etc) * Creates, maintains, and executes high-quality agency strategies and plans to achieve direct written premium, profit and new business goals, such as strategic and tactical components and alignment with key commercial business strategies including carrier consolidation (book transfer), agency force expansion and new product/program rollout support * Leads the agency review and joint planning process. Collaborates with agencies, branch underwriting and management to develop specific business plans which outline performance goals and strategies, and address key issues within the partnership * Creates tactical sales plans that provide for the profitable growth of targeted business segments * Regularly monitors and proactively modifies agency plans according to their performance data, such as production growth, profitability, business mix and retention, submission quality, account payment, and technological services * Recommends the cancellation of underperforming agencies. Communicates branch decision to the agencies and cancels contracts per branch and regulatory guidelines * Provides agency leadership with profitability and production progress reports throughout the year to keep the agency informed of key compensation and/or other incentive qualifiers * Serves as a mentor to the branch team to foster understanding of unique agency relationships, operations and processes. Initiates active collaboration with underwriting or other team members to answer questions and provide recommendations for complex situations, such as difficult accounts. Assists with other challenging communication and socialization strategies as it pertains to problematic agency relationships and clarifies the rationale for the recommendations Education & Experience: * Bachelor's degree, preferably in marketing or business or equivalent relevant work experience * Five years of experience in property and casualty underwriting, claims, sales territory development, or agency, or related experience * Insurance designations, such as CPCU or CIC, or an agent license preferred Knowledge, Skills & Abilities: * Excellent knowledge of property and casualty insurance industry * Advanced knowledge of independent agency operations, market conditions and competitor information * Exceptional problem-solving skills and the ability to make sound decisions * Excellent sales and negotiating skills * Excellent verbal and written communication skills, including presentation skills * Excellent organizational, time management and planning skills * Strong problem-solving abilities and interpersonal skills * Ability to work independently * Strong computer skills, including knowledge of Microsoft Office and social media * Demonstrated leadership qualities * Travel required; valid driver's license with an acceptable motor vehicle report per company standards required if driving The hiring salary range for this position will vary based on geographic location, falling within either the $83,925.00- $115,647.00 range or the $92,509.00-$127,495.00 range. A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.
    $92.5k-127.5k yearly Auto-Apply 48d ago
  • Risk Control Specialist - TX

    EMC Insurance Group 4.6company rating

    Remote or Texas job

    At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together. **This position can be performed remotely for candidates who reside in the Dallas/Fort Worth, Texas area** Essential Functions: Completes on-site risk control surveys of highly sophisticated current and prospective policyholders' operations, including in niche markets Assesses and analyzes the exposure potential and existing controls and prepares risk control reports based on findings and communicates results to insured and agents Provides consultation to policyholders regarding their operations, claims trends, and recommendations for improvement related to insured coverages, including developing written recommendations for policyholders to control hazards and to prevent or reduce exposure to insured losses Consults with policyholders to understand their service needs and concerns and customizes consultative services to address loss drivers and exposures to meet insured's needs, as well as other identified areas of need Serves as a primary technical resource within assigned specialized focus area and provides technical expertise and guidance to other Risk Control team members Collaborates with other Risk Control team members and subject matter experts on advanced technical questions as needed Provides updates to other departments such as Underwriting, Sales, and Claims to improve renewal decision making, including communicating unique observations identified to underwriting to aid in the decision making with accounts Markets risk control functions in coordination with the branch team through agency visits, presenting at agency and association meetings, etc Provides detailed explanation of business operations, hazards, and controls associated with coverages Delivers advanced training and on-site loss control surveys for current and prospective accounts Identifies accounts that would benefit from ongoing, routine service, and/or focused short-term service Analyzes previous losses and current exposures for large complex accounts, utilizing specialized knowledge to develop appropriate service plan(s) Provides comprehensive, tailored services, such as hazard control assessments, ergonomic surveys, or slip-fall surveys, to address loss drivers and exposures while meeting insureds' needs and documents in a service report Develops positive relationships with accounts and agents Other duties as assigned Education & Experience: Bachelor's degree, preferably in a safety, engineering, industrial safety, fire protection related field or equivalent relevant experience Five years of experience in risk control or safety role, or related experience Certifications such as certified safety professional preferred Knowledge, Skills & Abilities: Good computer skills, including Microsoft Office Suite Strong knowledge of industrial, construction, fire, and commercial automotive safety Good knowledge of various nationally recognized standards and codes, including OSHA, DOT and NFPA Strong ability to understand and evaluate risk Good ability to identify and visualize potential loss exposures Strong problem-solving skills Strong customer service skills Ability to work effectively with others, as well as independently Ability to multi-task and prioritize to meet deadlines Good verbal and written communication skills, including documentation skills Travel required; a valid driver's license with an acceptable motor vehicle report per company standards required if driving The hiring salary range for this position will vary based on geographic location, falling within either of the following: $90,635 - $124,914 or $99,924 - $137,714 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit *********************** Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.
    $99.9k-137.7k yearly Auto-Apply 8d ago
  • Senior Software Engineer

    EMC Insurance Group Inc. 4.6company rating

    Remote or Myrtle Point, OR job

    At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together. This job is fully remote and can be located anywhere in the U.S. Essential Functions: Designs and maintains assigned applications and processes: * Leads the development, configuration, and implementation of solutions within multiple complex, inter-related systems, employing advanced programming frameworks, tools, and techniques to deliver scalable and maintainable applications * Architects, deploys, and continuously optimizes cloud-native and hybrid environments, implementing strategies to maximize scalability, security, reliability, and cost-efficiency * Oversees the design and management of N-tier application structures, ensuring seamless integration and performance across presentation, business, and data layers while service as a subject matter expert to team members in best practices * Collaborates with IT stakeholders to resolve complex challenges, ensuring interfaces with enterprise and third-party applications execute securely and efficiently * Designs and implements modular, reusable components and APIs, proactively addressing cross-system dependencies and ensuring robust application support * Serves as a technical representative of assigned programs/applications and partners with product teams to align technical solutions with business objectives, balancing short-term deliverables with long-term architectural goals * Builds and manages CI/CD pipelines, introducing advanced automation techniques and tools to improve quality, reduce cycle times, and enhance deployment reliability * Authors and maintains comprehensive documentation for interfaces, APIs, and system designs, ensuring alignment with organizational standards and facilitating knowledge sharing * Participates in the defining of coding, design, and architecture standards while contributing to team-wide best practices to promote innovation and maintain system integrity Security Administration and Quality: * Leads product teams in implementing robust access control and security measures for various enterprise-wide software tools * Develops and enforces testing strategies, leveraging test-driven development and automated testing frameworks to ensure system reliability and maintainability * Designs security protocols, including encryption or password protection, and ensures appropriate application to systems * Collaborates with product teams to prioritize and address security vulnerabilities and quality concerns, driving the remediation of identified issues * Creates and executes comprehensive test plans, ensuring configurations meet business requirements, scalability needs, and compliance standards * Plans and guides a strategy with product teams about remediation of issues with security, data quality and integrity of systems Leadership/Technical Expertise * Guides and serves as a technical expert to team members on advanced programming techniques, system functionality, and best practices * Evaluates and refines team processes, advocating for improvements that enhance efficiency, collaboration, and quality * Provides leadership and guidance to product teams in latest technology, standards and processes * Builds strong partnerships with product owners, architects, and other stakeholders, providing technical insights to align development efforts with business goals Emerging Technology * Evaluates and pilots emerging technologies, tools, and frameworks to assess potential impact on existing systems, development processes, and business goals, providing recommendations for adoption * Collaborates with product teams and Solution Architects to design and implement proof-of-concept solutions that demonstrate the feasibility and value of new technologies in addressing business challenges. * Serves as a technical expert and resource to team members on the effective use of newly adopted tools and technologies System Troubleshooting & Monitoring: * Leads the implementation of monitoring and alerting tools, providing expertise in observability practices to ensure early detection and resolution of potential issues * Diagnoses and resolves intricate system issues, reproducing and verifying problems, and collaborating with stakeholders to implement robust, long-term solutions * Leads efforts to monitor and maintain the reliability of assigned programs, diagnosing and correcting complex errors in logic and coding, and providing guidance to other engineers on resolving issues * Continuously monitors and analyzes system performance, identifying trends, bottlenecks, and areas for improvement. Proactively implements optimizations to enhance reliability, scalability, and compliance with standards * Contributes to post-incident reviews and shares insights to prevent future occurrences, fostering a culture of continuous improvement and operational excellence Education & Experience: * Bachelor's degree, preferably in a computer related field or equivalent related experience and eight years of programming experience in techniques and languages such as C#, Java, or Python OR * Master's degree, preferably in a computer related field or equivalent related experience and six years of programming experience in techniques and languages such as C#, Java, or Python * Prior experience with AWS preferred Knowledge, Skills & Abilities: * Excellent knowledge of object-oriented programming concepts * Excellent knowledge of relational databases and data modeling * Excellent knowledge of cloud services * Advanced knowledge of web development * Excellent knowledge of REST architecture * Excellent knowledge of source code control * Strong knowledge of Agile development * Excellent knowledge of Test-Driven Development * Excellent human relations and customer service skills * Thorough attention to detail, organizational and multi-tasking skills * Strong verbal and written communication skills, including documentation * Superior analytical and problem-solving abilities to identify problems and implement effective solutions * Ability to work after hours on call as needed The hiring salary range for this position will vary based on geographic location, falling within either of the following: $101,677 - $145,733 or $112,094 - $160,670 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit *********************** Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.
    $112.1k-160.7k yearly Auto-Apply 18d ago
  • Medical Director, Psychiatry (SafetyNet & Behavioral Health)

    Excellus Health Plan 4.7company rating

    Remote or Buffalo, NY job

    This position assists the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. This a flexible hybrid/remote role! Essential Accountabilities: Level I Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective implementation of performance improvement initiatives for capitated providers. Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members. Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements. Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership. Oversees the activities of physician advisors. Utilizes the services of medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. Participates in provider network development and new market expansion as appropriate. Assists in the development and implementation of physician education with respect to clinical issues and policies. Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components. Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care. Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality. Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment. Develops alliances with the provider community through the development and implementation of the medical management programs. May represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues, as needed. Represents the business unit at appropriate state committees and other ad hoc committees Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values and adhering to the Corporate Code of Conduct. Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Conducts periodic staff meetings to include timely distribution and education related to departmental and Ethics/Compliance information. Regular and reliable attendance is expected and required. Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) Reviews medical literature and applies evidence-based principles using high proficiency skills for a broad range of clinical services. Reviews internal trend reports to assess present and future needs and opportunities. Interacts with regulatory and accreditation agencies as assigned. Provides clinical support to the Sales and Marketing divisions Provides clinical leadership for the implementation of new utilization/case/quality management initiatives Minimum Qualifications: Level I New York State licensed physician. Minimum 7 years of experience in a BH managed care settings or BH clinical setting (at least 2 of which are in a clinical setting). This experience begins at the conclusion of any residency and/or fellowship training. Board certification in general psychiatry or certification in addiction medicine or certification in the subspecialty of addiction psychiatry. Appropriate training and expertise in general psychiatry and/or addiction disorders. Ability to identify, analyze and resolve complex medical issues. Skills in evidence-based medicine. Strong interpersonal skills essential for communication to staff at all levels of the organization., Basic skill sets in electronic communication systems such as e-mail and Word. Level II (in addition to Level I Minimum Qualifications) Superior evidence-based medicine skill set Strong interpersonal skills essential for communication to physicians in the community. Strong verbal presentation skills to lead internal and external discussions at board levels Advanced skill sets in electronic communication systems such as e-mail, Word, PowerPoint, and Excel. Physical Requirements: Ability to work prolonged periods sitting at a workstation and working on a computer. Ability to work while sitting and/or standing while at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time. Typical office environment including fluorescent lighting. Ability to work in a home office for continuous periods of time for business continuity. Ability to travel across the Health Plan service region for meetings and/or trainings as needed. Ability to lift, carry, push or pull 15 pounds or less. Manual dexterity including fine finger motion required. Repetitive motion required. The ability to hear, understand and speak clearly while using a phone, with or without a headset. ************ In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer Compensation Range(s): Min: $202,000 - Max: $303,000 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
    $202k-303k yearly Auto-Apply 48d ago
  • Claims Support (Hybrid)

    NYCM Insurance 4.1company rating

    Remote or Edmeston, NY job

    Claims Support's responsibility is to provide a supporting role for the Auto, Casualty and Property Claims divisions. Accuracy and timeliness of Support assignments have a direct impact on the claim experience and compliance with numerous insurance regulations. Duties & Responsibilities: Filing Distribution (forms, letters, checks, reports). Printing as necessary from eDocs and websites. Dictation/Maintain Transcript Log. Contents Loss Inventory spreadsheet. Assist appraisers and adjusters. Document Medicare file reviews and reporting information. Generate simple payments (adjusting, tow bills, med bills, SALVB & SALVBC, etc.). Obtain claim check copies. Limited uses of databases (such as Reg83). Set up claim (PACE). Process CD requests and Microfilm requests. Enter draft payments to claim file. Rename/re-index docs. Process police report requests and update claim file upon return. Deposit salvage/Review subro and salvage, tow, and glass checks. Complete claims processes and transactions involving confidential and sensitive information. Responsible for all reinsurance support tasks. Review/process stale dated drafts/checks. Maintain DB on PACE, such as Providers. Process all tax levies. Research and process approved appraisal payments. Liability file set up. Loss set up AS400/coding. Complex PACE updates (DOL change, etc.). Access financial institutions (Stop pay). Moderate/Advanced database usage. Process more complex financial transactions, such as ROL and ROA. Issue any/all liability/subro payments. Process incoming mail/Process return mail. Mailing all forms, letters, checks and transcriptions. Maintain knowledge of Medicare reporting laws. Determine reportable injured parties through Medicare maintenance queues and provided reports. Pend medical bills, as needed, for further contact as necessary to obtain information. Research and correct any errors identified after the quarterly Medicare submissions are returned. Report BI settlements on all Medicare eligible claims. Meet monthly and quarterly filing requirements. Research problem mail. Review/analyze reports (Loss04, Loss25, Loss20 etc.). Review claim files, reports, and medical bills to obtain reportable details. Recheck claim file reports and forms as well as contact injured parties by letter and/or telephone to obtain missing or incorrect information. Perform ISO decision net search for social security numbers and/or date of birth. Requirements: High School Diploma Skills & Qualifications: Understand the Medicare maintenance queues, actuate reports, and reports provided by analytics to aid in determining reportable injured parties. Knowledge of CPT, ICD9 & ICD10 medical codes. Good keyboarding and computer skills. Ability to work within a team. Attention to detail. Ability to follow established processes and instructions. Appropriate claim file documentation. Phone skills. Ability to multitask and prioritize. Effectively communicate and work with all Claims divisions as applicable. Market Range 1 / 40 hours per week / Hybrid Salary: $33,700-$48,600 Accepting applications through: 12/29/25
    $33.7k-48.6k yearly 21d ago
  • Senior Commercial Underwriter

    EMC Insurance Group 4.6company rating

    Remote job

    At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together. **Ideal candidate will be located in Nebraska, Colorado, South Dakota, Wyoming, or Utah.** Essential Functions: Selects, grows and maintains a profitable book of business for assigned high-volume territory with a high level of underwriting authority Evaluates and analyzes highly complex accounts for risk selection and pricing purposes Develops and fosters agency relationships Collaborates with marketing representatives to ensure agents receive superior customer experiences Offers appropriate coverage for exposures and explains decisions to agents Coordinates with marketing and branch management in the agency planning and review processes Serves as a mentor for less experienced underwriters Education & Experience: Bachelor's degree, preferably in insurance or business administration Five years of experience in commercial lines underwriting Insurance designations, such as CPCU preferred Knowledge, Skills & Abilities: Excellent knowledge of underwriting and risk analysis Exceptional problem-solving skills and the ability to make sound decisions Strong customer service skills Strong computer skills, including knowledge of Microsoft Office and social media Ability to work on multiple projects while meeting deadlines Excellent written and verbal communication skills, including the ability to speak effectively before groups Strong presentation skills preferred Ability to work effectively with others, as well as independently Demonstrated leadership qualities Occasional travel; a valid driver's license with an acceptable motor vehicle report per company standards required if traveling The hiring salary range for this position will vary based on geographic location, falling within either the $83,000-$115,000 range or the $92,000-$127,000 range. A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.
    $92k-127k yearly Auto-Apply 60d+ ago
  • Industry Segment Manager - Construction

    EMC Insurance Group Inc. 4.6company rating

    Remote or Myrtle Point, OR job

    At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together. This position is eligible to work from home anywhere in the United States Essential Functions: * Leads, researches, and coordinates the strategy execution, day-to-day administration and/or development of assigned program at enterprise level * Serves as the subject matter expert for assigned program, providing strategic direction across the business unit * Develops comprehensive program strategies and implementation plans to ensure successful execution at the organizational level * Collaborates across functional teams, including line of business (LOB) leaders, actuarial, Loss Control, and claims teams to refine existing coverage offerings and design new coverage solutions for established programs * Oversees the formulation of short- and long-term strategies and underwriting initiatives within the program, aligning with enterprise-wide objectives to drive business growth and profitability * Maintains primary responsibility for profit and loss management within the assigned program, developing and maintaining the program's business plan to ensure financial stability and success * Establishes and communicates best practices and underwriting guidelines fostering consistency and excellence in underwriting operations * Conducts detailed analyses of premium and loss data, along with other key financial reports, on a monthly and quarterly basis to support sustainable and profitable growth * Proactively advises and collaborates with management, providing recommendations for strategic improvements to meet organizational goals and enhance underwriting outcomes * Drives innovation through the development of new product concepts, evaluation of existing offerings, and refinement of coverage language to optimize market competitiveness * Assesses the cost-benefit implications of market opportunities and product initiatives, recommending data-driven actions, including product enhancements, to strengthen the enterprise's market position * Evaluates complex underwriting risks and provides analysis and guidance to the specialty underwriting team in determining the acceptability of business * Assesses coverage, limits, and pricing on complex accounts and provides underwriters with authorizations on accounts above their authority * Provides leadership in the strategic research, administration, development, and continuous optimization of new business unit programs, ensuring alignment with organizational objectives and industry best practices * Identifies market opportunities, analyzes competitive positioning, and develops program enhancements to drive sustainable growth and profitability. * Leads efforts to refine underwriting frameworks, policy structures, and risk assessment methodologies to enhance the effectiveness and efficiency of business unit operations * Engages in extensive cross-functional collaboration with key stakeholders, including line of business (LOB) leaders, actuarial, Loss Control, and claims teams to facilitate the development of innovative programs that address emerging market demands and evolving risk profiles * Works closely with actuary teams to analyze key data trends, assess financial impact, and establish sound pricing strategies that optimize risk management while maintaining competitiveness. * Provides strategic direction to claims teams to ensure alignment between coverage offerings and claims management practices, fostering consistency and operational excellence * Acts as a key advisor to senior leadership, offering insights and recommendations to support enterprise-wide decision-making related to new program development and strategic growth initiatives * Partners with and provides underwriting expertise to departments within the company, including organizing and assisting in preparation and teaching of underwriting workshops and seminars for underwriting teams * Acts as a speaker or instructor for internal training exercises or meetings, and provides input or prepares articles, white papers, and underwriting bulletins on complex issues * Reviews insurance publications and keeps current on issues by attending seminars and participating in formalized continuing education * Represents the Specialty Business unit and EMC on various committees and events as appropriate and approved * Partners with the Quality Assurance (QA) team to design, establish, and implement comprehensive internal auditing procedures, ensuring alignment with organizational standards and regulatory requirements * Engages in strategic collaboration with underwriting (UW) leadership to assess team performance, identify areas of strength and opportunities for improvement, and develop structured initiatives to drive meaningful change and enhance operational efficiency Education & Experience: * Bachelor's degree, preferably in a business or insurance related field, or equivalent relevant experience * Ten years of commercial property and casualty underwriting including at least five years of staff underwriting experience in specialty program or related experience * Experience in the West territory strongly preferred (ID, UT, AZ, NV) * Insurance designations, such as CRIS, AU, CIC, or CPCU preferred Knowledge, Skills & Abilities * Advanced, proven knowledge of countrywide underwriting techniques, terminology, policies, and forms in applicable business area * Excellent underwriting judgment and decision-making skills * Strong knowledge of key performance indicators (KPIs) and ways to improve them * Advanced written and verbal communication skills, including presentation skills * Ability to work effectively with others, as well as independently and possess demonstrated problem-solving abilities * Strong computer knowledge, Internet and keyboarding skills * Strong ability to advise, partner, influence and effectively consult with diverse internal and external stakeholders, including senior leaders, executives, and project owners * Strong ability to distill and communicate highly complex issues for technical and non-technical audiences * Strong ability to translate technical ideas into more general terms for business customers * Occasional travel; a valid driver's license with an acceptable motor vehicle report per company standards required if driving The hiring salary range for this position will vary based on geographic location, falling within either of the following: $109,818 - $157,391 or $121,061 - $173,534 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit *********************** Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.
    $121.1k-173.5k yearly Auto-Apply 18d ago
  • Staff Data Platform Engineer

    EMC Insurance Group Inc. 4.6company rating

    Remote or Myrtle Point, OR job

    At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together. This job is fully remote and can be located anywhere in the U.S. Essential Functions: * Designs and evolves the data platform using Snowflake, DBT, Sigma, and AWS (Glue, Lambda, SageMaker), ensuring performance, modularity, and scalability for analytics and AI workloads. * Creates and communicates clear architecture direction for software and product team services, which build upon and improve operational effectiveness and efficiencies. * Designs infrastructure and workflows that support machine learning and generative AI use cases, including semantic modeling, feature engineering, and model deployment pipelines. * Identifies trends in technology and anticipates new requirements; recommends and supports strategies to leverage emerging and innovative technologies. * Builds and maintains sandbox environments for experimentation with predictive models, LLMs, and real-time analytics using Snowflake ML and AWS AI services. * Guides integration of machine learning and generative AI into data pipelines and analytics workflows, enabling use cases like semantic search, predictive modeling, and intelligent automation. * Recommends and presents technology applications strategy to meet the current and future needs of respective business areas. * Ensures foundational patterns (e.g., DBT macros, ML preprocessing frameworks) align with enterprise architecture and support AI/ML scalability, governance, and compliance. * Recommends and supports the technical strategy and alignment of data platform capabilities with the business objectives of EMC. * Partners with Data Platform Operations, Information Security, Network, Cloud Engineering, and DevOps teams to lead the design and implementation of new business initiatives as related to data and analytics. * Partners with Platform Operations, Analytics Engineering, and DAP teams to embed AI-ready data platform(s) into data products and ensure alignment with business outcomes. * Serves as a subject matter expert in data analytics platform(s) and AI/ML strategy, influencing platform innovation and guiding teams on best practices for scalable, intelligent data systems. * Serves as a technical resource for Data Platform team members on complex questions or issues. * Designs and recommends software engineering governance policies, procedures, and roles, including proper development techniques and quality management following established SDLC procedures. * Partners with Information Security to create and maintain security and procedures aligned and documented to risk management requirements. * Partners with Enterprise Architecture team to incorporate the creation of patterns and services into reference architecture and SDLC. * Provides guidance for building and maturing assigned solution platforms through automation and reusable processes. * Recommends and supports patterns that guide engineering team members in creating data solutions. * Enhances enterprise engineering practices by sharing expertise in creating engineering processes, alerting, and metrics. * Performs other duties as assigned. Education & Experience: * Bachelor's degree, preferably in computer science, data science, engineering, or related field, or equivalent relevant experience * Ten years of experience in data architecture, data engineering, or advanced analytics or related experience * Experience defining high-level data architecture or technical vision for large projects preferred Knowledge, Skills & Abilities: * Excellent ability to design enterprise data architectures using tools such as Snowflake, DBT, and AWS * Deep understanding of analytics platforms (e.g., Sigma Computing) and data modeling principles * Strong proficiency in AI/ML tools and frameworks, including Python, scikit-learn, XGBoost, LightGBM, TensorFlow, PyTorch, AWS SageMaker, Snowflake ML, SQL-based predictive modeling * Excellent knowledge of semantic modeling, feature engineering, model interpretability, and MLOps * Advanced ability to translate business needs into scalable, AI-enabled technical solutions * Familiarity with modular architecture, automation frameworks, and data governance * Excellent communication and collaboration skills across technical and business stakeholders The hiring salary range for this position will vary based on geographic location, falling within either of the following: $109,818 - $157,391 or $121,061 - $173,534 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit *********************** Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.
    $121.1k-173.5k yearly Auto-Apply 18d ago
  • Manager of Actuarial Services

    Excellus Health Plan 4.7company rating

    Remote or Rochester, NY job

    The Manager of Actuarial Services is responsible for managing a team that preforms financial projections and actuarial analyses for complex projects in support of our organization's diverse product portfolio. This role will oversee the development of actuarial assumptions and analysis of actuarial research to determine appropriate claim reserves and related liabilities, forecasts financial results; prepares financial reports; establishes insurance rates, rate structures, and rating systems; develops ad hoc and regulatory reports to various internal and external entities. This role ensures actuarial modeling is consistent with Actuarial Standards of Practice developed and promulgated by the Actuarial Standards Board. Essential Accountabilities: Oversees the development and maintenance of sound liability estimation methodologies. Manages recommendations for reserves for blocks of business and in total, organizes analyses to support recommendations. Leads preparation of accruals/liabilities for CMS Part D risk sharing and Part C revenue settlements. Leads preparation and submission of NYS Insurance Department quarterly and annual reports, including NAIC, NY Supplement and HMO Statements. Leads preparation and submission of Regulation 146 and Direct Pay Stop Loss reports to the NYS Insurance Department. Oversees the submission and quality of NYS and CMS regulatory encounter submissions and supports all required audits, internal and external to ensure accuracy. Leads preparation reporting, valuation, and forecasting of risk adjustment scores and revenue to support partners internal and external, including providers and vendors. Manages the development of financial plans, forecasts, and other financial projections. Prepares, or obtains externally, actuarial statements of opinion for rate and product filings and financial statements for assigned business segments. Leads preparation of Medicare Advantage bids and coordinates CMS bid review responses. Recommends regional or product line profitability targets; ensures pricing is consistent with established targets for those business segments priced in actuarial. Develops and maintains rates, rating factors and rate filings. Develops and maintains rating methods and models. Provides guidance to the Health Plan product development process. Oversees the development of competitive product and rate comparisons and analyzes competitive developments in the marketplace. Monitors developments in actuarial techniques, researches laws and regulations applicable to actuarial science and insurance operations. Provides counsel on current and proposed health plan Underwriting guidelines for commercial and Medicare eligible subgroups. Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs. Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Maintains knowledge of all relevant legislative and regulatory mandates and ensures that all activities are compliant with these requirements. Conducts periodic staff meetings to include timely distribution and education related to departmental and Ethics/Compliance information. Regular and reliable attendance is expected and required. Performs other functions as assigned by management. Minimum Qualifications: Bachelor's degree in math, economics, actuarial science, or related field required. Seven (7) years of actuarial experience. Exam progression or professional credentials, such as ASA, FSA or MAAA preferred. Prior experience supervising or managing people and/or projects or indirectly leading teams. Advanced knowledge of financial and risk health arrangements. Strong skills including proficiency in Microsoft Office, SAS and Cognos. Strong verbal and written communication skills with the ability to present clear and concise information to all audiences. Ability to design and implement process improvements. Ability to translate technical concepts into business language. A thorough understanding of non-Actuarial functions such as Rating & Underwriting, Finance, Provider Contracting, Network Management, Product Development, Medical Management, Marketing & Sales, etc. and how they impact Health Plan operations, financials and forecasts. In depth understanding of Actuarial Standards of Practice developed and promulgated by Actuarial Standards Board. Physical Requirements: Ability to work prolonged periods sitting and/or standing at a workstation and working on a computer. Ability to travel across the Health Plan service region for meetings and/or trainings as needed. ************ In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer Compensation Range(s): Grade E10: Minimum $123,304 - Maximum $221,948 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
    $68k-94k yearly est. Auto-Apply 27d ago
  • Customer Relationship Manager (Remote, Maumee OH)

    One Inc. 4.4company rating

    Remote or Maumee, OH job

    Now is a great time to join AllianceOne! As a subsidiary of Teleperformance, AllianceOne provides employees the opportunity to be part of a global leader in contact center management, with the benefit of capitalizing on the global presence the company has built throughout the years. Teleperformance creates more value by providing a better customer experience. Job Description: Now Hiring Customer Relationship Managers in Maumee OH! (Remote after Day 1, must reside within 30 miles of Maumee OH) If you are looking for an entry level position with opportunities for advancement you have found the right organization! This is a care program centered on mortgage assistance and foreclosure prevention. RESPONSIBILITIES: -Manage a daily caseload of customers and their investor related activities -Provide the highest level of customer service via inbound/outbound calls as well as written communications -Evaluate customer's eligibility for various COVID-19 payment assistance programs and complete financial interviews to determine next steps for loan modification and returning their loans to normal servicing QUALIFICATIONS: - Prior customer service experience (call center/banking experience is a plus) · Excellent verbal communication skills · The ability to problem solve creatively · Strong desire to achieve goals · Basic computer knowledge/skills · Ability and openness to work with a diverse customer base · Works well in team settings *Must be able to come to the Maumee office on the first day to collect equipment - 1684 Woodlands Dr, Maumee, OH 43537 HOURS: Monday - Friday 11am- 8pm (After Training) PAY: $16/hour BONUS: Eligible for up to $400 per month in monthly incentives. BENEFITS: Our comprehensive benefits include, but are not limited to: Health Insurance (Medical/Dental/Vision), HSA/FSA plans, Generous Paid Time Off package, Optional Daily Pay, EAP, 401k after 90 days and much more! You will be eligible for Health benefits on the first of the month following your hire date, or coincident to your hire date if you were hired on the first of the month. If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us! AllianceOne is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. AllianceOne is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. To request reasonable accommodation please email us at *****************************. Questions? Please review our privacy notice available at the following ****************************** For additional information on AllianceOne visit our website at **********************
    $16 hourly Auto-Apply 60d+ ago
  • Network Management & Contract Analyst

    Excellus Health Plan 4.7company rating

    Remote or Rochester, NY job

    As a professional within the network contracting and administration team, the incumbent will contribute to the development and maintenance of provider networks. This position is accountable for performing provider and network analysis, evaluating provider reimbursement, and negotiating provider contracts in accordance with corporate strategy. As such, the role requires a multifaceted understanding of provider types, applicable legal and regulatory requirements, pricing methodologies, industry and regional provider impacts & trends, provider reimbursement and related programs, and product lines. Essential Accountabilities: • Establishes and maintains network adequacy for assigned provider types, regions and/or lines of business. Serves as provider network contracting and administration subject matter expert for assigned areas. • Analyzes, develops, and proposes formal provider reimbursement recommendations within approved budgets and according to health plan strategies. • Identifies, investigates, and analyzes issues and questions. Collects and interprets data and information to support provider network contracting and administration activities. Applies applicable contract terms, regulatory and legal requirements, and other information to produce accurate and actionable analysis. • Effectively prepares and presents information, findings, and recommendations to internal and external stakeholders. • Serves as liaison with assigned stakeholders to identify and coordinate provider network contract and administration work items. Executes initiatives; tracks, forecasts and reports on progress including qualitative and quantitative measures. • Engages in provider contract negotiations. Works routinely and directly with providers, clinical, and operational leadership. • Assist in the preparation of provider contracts, amendments, and communications. • Maintains knowledge of relevant legislative and regulatory mandates to ensure compliance. • Responds to and resolves inquiries from providers and colleagues related to provider network contracting and administration. Leads issue resolution with internal and external stakeholders. • Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs. • Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. • Regular and reliable attendance is expected and required. • Performs other functions as assigned by management. Minimum Qualifications: • Six (6) years of provider network reimbursement or related experience required. Or a Bachelor's degree in Health Care Administration or relevant field. • Two (2) years of experience directly performing provider contracting or reimbursement analysis required. • Demonstrated experience of provider reimbursement methodologies. • Ability to draft, interpret and apply contractual language. • Technical skills including modeling and financial analysis. • Understanding of medical care delivery, industry trends, and regional market dynamics. • Strong, persuasive, and effective verbal and written communication skills. • Knowledge of health care products and services offered to members. • Excellent problem-solving skills. Physical Requirements: • Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time. • Ability to travel across the Health Plan service region for meetings and/or trainings as needed. ************ In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer Compensation Range(s): Grade E3: Minimum $60,410 - Maximum $106,929 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
    $60.4k-106.9k yearly Auto-Apply 29d ago
  • Underwriting Product Director - Property

    EMC Insurance Group 4.6company rating

    Remote or Iowa job

    At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together. **This role can be performed remotely anywhere in the US** Essential Functions: Serves as assigned line of business subject matter expert to provide strategic direction enterprise wide. Develops line of business strategies and plans, and ensures successful implementation enterprise wide. Leads the administration and development of products and programs for assigned line of business Leads the process of the developing of short- and long-term strategic product and underwriting strategies within LOB in support of enterprise-wise business and profitability goals Maintains primary oversight of the profit and loss for assigned LOB. Develops and maintains the business plan for assigned LOB Analyzes premium and loss data and other key reports on monthly and quarterly basis to ensure long-term profitable growth Analyzes underwriting and loss results and determines underlying trends that impact results. Recommends actions to drive profitable growth Creates, maintains, and communicates best practices and underwriting guidance to the whole enterprise. Develops new product ideas, reviews existing products, and drafts new coverage language. Oversees new product ideas developed within team and subsequent implementation across the organization Proactively communicates and makes necessary recommendations to management for improvement needed to meet company goals and improve underwriting results Evaluates the cost and benefit of market opportunities and product initiatives, and recommends actions based on evaluation, including identifying product improvements for complex products Provides analysis for state and countrywide rate reviews as well as to aid branch partners in efforts at profitability improvement and profitable production by providing recommendations and support to drive profitable growth Reviews insurance publications and keeps current on issues impacting LOB by attending seminars and participating in continuing education Serves as a sought-after subject matter expert frequently consulted for initiatives and special projects within assigned LOB Manages business relationships with external and internal partners to introduce and integrate product initiatives based on enterprise needs Initiates and assists in the preparation of underwriting workshops and seminars for the company Acts as a speaker or instructor for internal training exercises or meetings, and provides input or prepares articles on the most complex issues. Reviews and studies proposed changes in rules, rates, and forms for assigned LOB for both EMC proprietary and controlled by ISO Prepares any necessary changes and new information for company manuals, bureau and proprietary policy forms, and statistical coding Assesses the impact of proposed changes and determines the need for and timing of filings. Prepares documentation needed to obtain approval and makes recommendations for needed action Writes and prepares new proprietary endorsements as needed Coordinates with other corporate office departments to implement and communicate changes and impacts Reviews insurance publications and keeps current on issues by attending seminars and participating in continuing education Serves as the LOB subject matter expert by researching and reviewing state regulations, coverages, operational processes, underwriting criteria and system application and tools Receives and handles underwriting referrals from the field and/or segment Ensures that the team responds timely and collaborates closely with branch offices on underwriting philosophy, authorizations, and facultative reinsurance needs, etc. Provides guidance and direction in the development of underwriting and training tools at the branch and enterprise level Provides advice and guidance for branch authorizations in determining the acceptability of business by discussing underwriting philosophy, policy forms, rating approaches, underwriting and risk management techniques, including the largest and most complex risk submissions which may require a specialized approach Determines the need for and places facultative reinsurance Collaborates with team members to establish performance goals and monitors status, conducts performance reviews, and provides coaching Interviews, hires, and recommends salary adjustments for team members Resolves disciplinary issues, reviews results, action plans, and progress Develops team expertise and completes succession planning, including identifying talent and implementing development plans for critical positions Supports diversity, equity, and inclusion initiatives Fosters an innovative culture, including supporting new ideas and providing guidance on potential changes Develops and maintains department budget Education & Experience: Bachelor's degree, preferably in an insurance or business-related field, or equivalent relevant experience Ten years of experience with commercial property and casualty underwriting, including at least five years of commercial staff underwriting experience within applicable line of business Insurance certifications, such as CPCU, AU or CIC Previous people leadership experience Knowledge, Skills & Abilities: Superior knowledge of countrywide underwriting techniques, terminology, policies, products, and forms Exceptional underwriting judgment and decision-making skills Strong knowledge of key performance indicators (KPIs) and ways to improve them Proficiency with computer software and Microsoft Office Suite Superior written and oral communication skills Superior organizational and multi-tasking skills Excellent problem-solving and analytical abilities Excellent presentation, communication, and leadership skills Strong ability to advise, partner, influence and effectively consult with diverse internal and external stakeholders, including senior leaders, executives, and project owners Strong ability to distill and communicate highly complex issues for technical and non-technical audiences Strong ability to translate technical ideas into more general terms for business customers Occasional travel required; a valid driver's license with an acceptable motor vehicle report per company standards required if driving The hiring salary range for this position will vary based on geographic location, falling within either the $128,094-$183,584 range or the $141,211-$202,414 range. A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. The hiring salary range for this position will vary based on geographic location, falling within either of the following: $128,094 - $183,584 or $141,211 - $202,414 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit *********************** Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.
    $141.2k-202.4k yearly Auto-Apply 60d+ ago
  • Industry Segment Underwriting Manager - Transportation & Petroleum

    EMC Insurance Group Inc. 4.6company rating

    Remote or Myrtle Point, OR job

    At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together. This job is fully remote and can be located anywhere in the U.S. Job Summary: Provides strategic insights and leadership for the underwriting organization within assigned program. Oversees the research, development, and execution of product and program strategies at the enterprise level, ensuring alignment with organizational and business unit objectives. Establishes and communicates best practices and underwriting guidelines, fostering consistency and excellence within the Specialty Unit. Leads the innovation and enhancement of insurance products, including the development of new products and programs, the revision of existing coverage language, and the evaluation of market opportunities. Assesses the cost-benefit impact of product initiatives and recommends strategic actions to optimize market positioning, particularly for complex products. Serves as a strategic advisor to Specialty Unit underwriters, offering expert guidance on complex underwriting matters and organizational strategy. Conducts in-depth evaluations of intricate underwriting risks and provides comprehensive analysis and direction to underwriting staff to support informed decision-making and the acceptability of business. Essential Functions: * Leads, researches, and coordinates the strategy execution, day-to-day administration and/or development of assigned program at enterprise level * Serves as the subject matter expert for assigned program, providing strategic direction across the business unit * Develops comprehensive program strategies and implementation plans to ensure successful execution at the organizational level * Collaborates across functional teams, including line of business (LOB) leaders, actuarial, Loss Control, and claims teams to refine existing coverage offerings and design new coverage solutions for established programs * Oversees the formulation of short- and long-term strategies and underwriting initiatives within the program, aligning with enterprise-wide objectives to drive business growth and profitability * Maintains primary responsibility for profit and loss management within the assigned program, developing and maintaining the program's business plan to ensure financial stability and success * Establishes and communicates best practices and underwriting guidelines fostering consistency and excellence in underwriting operations * Conducts detailed analyses of premium and loss data, along with other key financial reports, on a monthly and quarterly basis to support sustainable and profitable growth * Proactively advises and collaborates with management, providing recommendations for strategic improvements to meet organizational goals and enhance underwriting outcomes * Drives innovation through the development of new product concepts, evaluation of existing offerings, and refinement of coverage language to optimize market competitiveness * Assesses the cost-benefit implications of market opportunities and product initiatives, recommending data-driven actions, including product enhancements, to strengthen the enterprise's market position * Evaluates complex underwriting risks and provides analysis and guidance to the specialty underwriting team in determining the acceptability of business * Assesses coverage, limits, and pricing on complex accounts and provides underwriters with authorizations on accounts above their authority * Provides leadership in the strategic research, administration, development, and continuous optimization of new business unit programs, ensuring alignment with organizational objectives and industry best practices * Identifies market opportunities, analyzes competitive positioning, and develops program enhancements to drive sustainable growth and profitability. * Leads efforts to refine underwriting frameworks, policy structures, and risk assessment methodologies to enhance the effectiveness and efficiency of business unit operations * Engages in extensive cross-functional collaboration with key stakeholders, including line of business (LOB) leaders, actuarial, Loss Control, and claims teams to facilitate the development of innovative programs that address emerging market demands and evolving risk profiles * Works closely with actuary teams to analyze key data trends, assess financial impact, and establish sound pricing strategies that optimize risk management while maintaining competitiveness. * Provides strategic direction to claims teams to ensure alignment between coverage offerings and claims management practices, fostering consistency and operational excellence * Acts as a key advisor to senior leadership, offering insights and recommendations to support enterprise-wide decision-making related to new program development and strategic growth initiatives * Partners with and provides underwriting expertise to departments within the company, including organizing and assisting in preparation and teaching of underwriting workshops and seminars for underwriting teams * Acts as a speaker or instructor for internal training exercises or meetings, and provides input or prepares articles, white papers, and underwriting bulletins on complex issues * Reviews insurance publications and keeps current on issues by attending seminars and participating in formalized continuing education * Represents the Specialty Business unit and EMC on various committees and events as appropriate and approved * Partners with the Quality Assurance (QA) team to design, establish, and implement comprehensive internal auditing procedures, ensuring alignment with organizational standards and regulatory requirements * Engages in strategic collaboration with underwriting (UW) leadership to assess team performance, identify areas of strength and opportunities for improvement, and develop structured initiatives to drive meaningful change and enhance operational efficiency Education & Experience: The education and experience below are required for the job unless labelled as preferred: * Bachelor's degree, preferably in a business or insurance related field, or equivalent relevant experience * Ten years of commercial property and casualty underwriting including at least five years of staff underwriting experience in specialty program or related experience * Minimum of three years of staff underwriting experience with petroleum marketers, transportation risks, and heavy auto fleets preferred * Insurance designations, such as AU, CIC, or CPCU preferred Knowledge, Skills & Abilities The knowledge, skills and abilities below are required for the job unless labelled as preferred: * Advanced, proven knowledge of countrywide underwriting techniques, terminology, policies, and forms in applicable business area * Excellent underwriting judgment and decision-making skills * Strong knowledge of key performance indicators (KPIs) and ways to improve them * Advanced written and verbal communication skills, including presentation skills * Ability to work effectively with others, as well as independently and possess demonstrated problem-solving abilities * Strong computer knowledge, Internet and keyboarding skills * Strong ability to advise, partner, influence and effectively consult with diverse internal and external stakeholders, including senior leaders, executives, and project owners * Strong ability to distill and communicate highly complex issues for technical and non-technical audiences * Strong ability to translate technical ideas into more general terms for business customers * Occasional travel; a valid driver's license with an acceptable motor vehicle report per company standards required if driving The hiring salary range for this position will vary based on geographic location, falling within either of the following: $109,818 - $157,391 or $121,061 - $173,534 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit *********************** Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.
    $121.1k-173.5k yearly Auto-Apply 40d ago
  • Risk Control Specialist - TX

    EMC Insurance Group Inc. 4.6company rating

    Remote or Texas job

    At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together. This position can be performed remotely for candidates who reside in the Dallas/Fort Worth, Texas area Essential Functions: * Completes on-site risk control surveys of highly sophisticated current and prospective policyholders' operations, including in niche markets * Assesses and analyzes the exposure potential and existing controls and prepares risk control reports based on findings and communicates results to insured and agents * Provides consultation to policyholders regarding their operations, claims trends, and recommendations for improvement related to insured coverages, including developing written recommendations for policyholders to control hazards and to prevent or reduce exposure to insured losses * Consults with policyholders to understand their service needs and concerns and customizes consultative services to address loss drivers and exposures to meet insured's needs, as well as other identified areas of need * Serves as a primary technical resource within assigned specialized focus area and provides technical expertise and guidance to other Risk Control team members * Collaborates with other Risk Control team members and subject matter experts on advanced technical questions as needed * Provides updates to other departments such as Underwriting, Sales, and Claims to improve renewal decision making, including communicating unique observations identified to underwriting to aid in the decision making with accounts * Markets risk control functions in coordination with the branch team through agency visits, presenting at agency and association meetings, etc * Provides detailed explanation of business operations, hazards, and controls associated with coverages * Delivers advanced training and on-site loss control surveys for current and prospective accounts * Identifies accounts that would benefit from ongoing, routine service, and/or focused short-term service * Analyzes previous losses and current exposures for large complex accounts, utilizing specialized knowledge to develop appropriate service plan(s) * Provides comprehensive, tailored services, such as hazard control assessments, ergonomic surveys, or slip-fall surveys, to address loss drivers and exposures while meeting insureds' needs and documents in a service report * Develops positive relationships with accounts and agents * Other duties as assigned Education & Experience: * Bachelor's degree, preferably in a safety, engineering, industrial safety, fire protection related field or equivalent relevant experience * Five years of experience in risk control or safety role, or related experience * Certifications such as certified safety professional preferred Knowledge, Skills & Abilities: * Good computer skills, including Microsoft Office Suite * Strong knowledge of industrial, construction, fire, and commercial automotive safety * Good knowledge of various nationally recognized standards and codes, including OSHA, DOT and NFPA * Strong ability to understand and evaluate risk * Good ability to identify and visualize potential loss exposures * Strong problem-solving skills * Strong customer service skills * Ability to work effectively with others, as well as independently * Ability to multi-task and prioritize to meet deadlines * Good verbal and written communication skills, including documentation skills * Travel required; a valid driver's license with an acceptable motor vehicle report per company standards required if driving The hiring salary range for this position will vary based on geographic location, falling within either of the following: $90,635 - $124,914 or $99,924 - $137,714 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit *********************** Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.
    $99.9k-137.7k yearly Auto-Apply 20d ago
  • Small Business Underwriting Assistant Manager

    EMC Insurance Group Inc. 4.6company rating

    Remote or Myrtle Point, OR job

    At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together. This position is eligible to work from home anywhere in the United States The Small Business Assistant Manager leads and supports an assigned Small Business underwriting team within EMC's Small Business Unit (SBU). This role is responsible for operational execution, talent development, quality assurance, and agency engagement for a defined territory or portfolio. The Assistant Manager ensures underwriters adhere to underwriting guidelines, authority levels, pricing standards, and service expectations while driving profitable growth across all Small Business lines. The role acts as a key connector between Small Business leadership, regional partners, Product Management, Operations, and Platform/Technology teams. This position plays an instrumental role in implementing SBU strategies, improving processes, coaching underwriters, strengthening agency relationships, and ensuring consistent, high-quality underwriting outcomes. Essential Functions: * Supervises assigned Small Business underwriting (SBU) team, ensuring alignment with SBU and Corporate Underwriting guidelines, service standards, and workflows. * Provides hands-on guidance on account strategy, risk selection, pricing adequacy, and appetite, supporting escalation and approval processes within authority. * Partners with Small Business leadership to operationalize strategies that improve profitability, strengthen risk selection, and reinforce underwriting discipline. * Engages with regional offices and collaborates with assigned underwriters to maintain, grow, and optimize existing agency relationships, identifying opportunities to expand high-value partnerships. * Conducts agency visits, virtual or in person, to enhance agent understanding of EMC capabilities, underwriting criteria, and digital solutions. * Partners with sales to identify and address challenges within underperforming or low growth agencies * Partners with Underwriting Operations and Leadership to identify workflow gaps, recommend process improvements, and streamline the quoting and binding experience across new and renewal business. * Collaborates with Small Business leadership to validate and implement updates to system rules, product changes, appetite adjustments, and workflow enhancements. * Reviews referral patterns, escalation types, and exceptions to identify training opportunities and recommended system rule refinements. * Ensures compliance with underwriting authority, regulatory requirements, and internal policy standards; assists with internal and external audit reviews as needed. * Oversees and monitors the workload and performance of assigned Small Business underwriting team and performs all duties expected of a people leader at EMC. Education & Experience: * Bachelor's degree, preferably in an insurance or business related field,, or equivalent experience * Eight years of commercial lines underwriting experience, including prior underwriting experience in small business * CPCU designation or other underwriting-related designation(s) preferred * Previous supervisory/leadership experience preferred * Prior experience with automated underwriting platforms or digital underwriting tools preferred Knowledge, Skills, & Abilities: * Excellent knowledge of underwriting, risk analytics, portfolio management, and pricing best practices * Strong industry knowledge of small business products * Strong leadership skills, including the ability to coach, motivate, and influence * High degree of business acumen with strong problem-solving and decision-making ability * Excellent written and verbal communication skills, including group presentations * Ability to manage multiple priorities, projects, and deadlines * High comfort working in evolving environments and navigating change * Strong collaboration skills with the ability to build partnerships internally and externally * Exceptional customer service skills * Proven ability to build and maintain agency relationships * Strong proficiency with Microsoft Office * Occasional travel; a valid driver's license with an acceptable motor vehicle report per company standards will be required if driving The hiring salary range for this position will vary based on geographic location, falling within either of the following: $97,889 - $134,921 or $107,944 - $148,758 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit *********************** Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.
    $107.9k-148.8k yearly Auto-Apply 12d ago
  • Territory Management Consultant

    EMC Insurance Group 4.6company rating

    Remote or Michigan job

    At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together. **This position can be performed remotely for candidates who reside in eastern or central Michigan with flexibility if living in nearby locations in Ohio or Indiana** Essential Functions: Oversees an assigned territory with broad and challenging agency partners driving profitable premium growth to achieve financial and operational goals Creates, implements and executes territory and agency strategies to achieve short term and long term goals utilizing all company programs, tools and resources in collaboration with internal business partners Leads a collaborative, proactive approach with underwriters to drive profitable premium growth within a territory through directing sales pipeline activity, identifying account leads and prospects, pre-qualifying business, and selling quotes and EMC to agents Creates demand by marketing EMC as a leader in the market. Enables agents/producers to maximize the flow of desirable business to meet or exceed goals Owns the business development process within assigned market area with heavy emphasis on developing a pipeline of profitable new business and renewal retention Continually identifies and evaluates prospects for new agencies within the territory. Surveys prospective agencies and obtains completed agency applications Identifies new agencies and effectively onboards the agency. Discusses company and agency responsibilities and establishes a business plan for the agency. Leads training of agencies on EMC products and services, rate levels, underwriting eligibility, sales techniques, EMC and agency technology, and other administrative processes Researches EMC's competitive position in the marketplace, proactively providing competitive intelligence to the branch and corporate offices as appropriate. Performs surveys of competitor products and services, rate levels, producer compensation and incentives, and marketing efforts Evaluates the impact of market conditions and representation by territory and recommends changes in agency representation within an assigned territory. Determines areas of the branch territory to further develop or expand market presence and leads recommendation discussions with appropriate branch team members Builds and cultivates complex agency partnerships in person with agency ownership, management and frontline team members Creates, drives, and manages strong producer relationships through high visibility, clear knowledge of company strategy and joint sales planning Drives the acquisition and evaluates complex new business accounts with agents through properly conveying branch and underwriting risk appetite, discussing leads and prospects, and pre-qualifying submissions and evaluating risks. Collaborates with underwriters to secure the acquisition of desirable individual accounts Establishes position as a subject matter expert while delivering product, underwriting philosophy, appetite and system training, and support retention and new business development to increase depth and maximize agency revenue Partners with existing and prospective independent agencies to develop a strategy to drive profitable business and sources of new business Leads, influences and supports internal business partners to identify and capitalize on opportunities, resolve problems, share key competitor and industry intel and provide a voice for our agent/customer Communicates with branch team about complex agency relationships and proactively coordinates actions to address potential issues, involving other departments as appropriate Serves as a consultant to the agency and branch to articulate and explain coverages, premiums and claim decisions, involving other departments as appropriate Leads and organizes various functions to promote EMC and/or represents EMC at special events, such as agency sales meetings, agency trade association meetings, etc. Builds and executes an effective agency management sales plan with broad and challenging agencies to achieve maximum production and profit goals in assigned territory Leads assigned geographical territory and agency management processes (e.g. agency prospecting, business planning, engagement, training, compensation, etc) Creates, maintains, and executes high-quality agency strategies and plans to achieve direct written premium, profit and new business goals, such as strategic and tactical components and alignment with key commercial business strategies including carrier consolidation (book transfer), agency force expansion and new product/program rollout support Leads the agency review and joint planning process. Collaborates with agencies, branch underwriting and management to develop specific business plans which outline performance goals and strategies, and address key issues within the partnership Creates tactical sales plans that provide for the profitable growth of targeted business segments Regularly monitors and proactively modifies agency plans according to their performance data, such as production growth, profitability, business mix and retention, submission quality, account payment, and technological services Recommends the cancellation of underperforming agencies. Communicates branch decision to the agencies and cancels contracts per branch and regulatory guidelines Provides agency leadership with profitability and production progress reports throughout the year to keep the agency informed of key compensation and/or other incentive qualifiers Serves as a mentor to the branch team to foster understanding of unique agency relationships, operations and processes. Initiates active collaboration with underwriting or other team members to answer questions and provide recommendations for complex situations, such as difficult accounts. Assists with other challenging communication and socialization strategies as it pertains to problematic agency relationships and clarifies the rationale for the recommendations Education & Experience: Bachelor's degree, preferably in marketing or business or equivalent relevant work experience Five years of experience in property and casualty underwriting, claims, sales territory development, or agency, or related experience Insurance designations, such as CPCU or CIC, or an agent license preferred Knowledge, Skills & Abilities: Excellent knowledge of property and casualty insurance industry Advanced knowledge of independent agency operations, market conditions and competitor information Exceptional problem-solving skills and the ability to make sound decisions Excellent sales and negotiating skills Excellent verbal and written communication skills, including presentation skills Excellent organizational, time management and planning skills Strong problem-solving abilities and interpersonal skills Ability to work independently Strong computer skills, including knowledge of Microsoft Office and social media Demonstrated leadership qualities Travel required; valid driver's license with an acceptable motor vehicle report per company standards required if driving The hiring salary range for this position will vary based on geographic location, falling within either of the following: $83,925 - $115,647 or $92,509 - $127,495 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit *********************** Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.
    $92.5k-127.5k yearly Auto-Apply 42d ago
  • Senior Data Platform Engineer

    EMC Insurance Group Inc. 4.6company rating

    Remote or Myrtle Point, OR job

    At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together. This job is fully remote and can be located anywhere in the U.S. Essential Functions: Technical Delivery and Strategic Initiatives: * Guides the Data Platform Engineers on highly complex projects related to fully operationalizing EMC's production data environments including alerting and monitoring, continuous integration/delivery/deployment (CI/CD) processes, data lifecycle and change management * Tracks, reviews work in progress and completed assignments for projects within areas of expertise and follows up with team to ensure solutions created meet stakeholder needs and deadline for all technical delivery of project work per quarterly goals * Guides team during planning in selecting tasks needed to deliver data services based on priorities set by stakeholders and team roadmap * Leads planning and execution of strategic initiatives as requested by stakeholders and defined in DPO roadmap * Ensures delivery of assigned projects required for completion of DPO team enablement initiatives Data Platform Development: * Collaborates with Data Analytics Architecture Director to define and implement shared services solutions to support Data Analytics Product (DAP) teams. Performs work and guides DPO team members in the following areas: * Operational Data Management - creates and maintains a central repository for logs to create metrics, observability, and incident root cause identification * Data Lake - leads the storage of data product files, enabling access as appropriate * Analytics Sandbox - provides guidelines for access, use, and data retention, monitors growth and organization of assets. Collaborates with Actuary, Data Science, and other teams for effective use of the sandbox * Cost of Ownership - creates automated methods for gathering information necessary for producing metrics to analyze costs per data technology, development team, and/or business process * Creates and documents guidelines and procedures used by the DPO team members in the following areas: * Data Access and Security - administers functional and resource roles, data discovery/classification and loss prevention * Data Lifecycle and Change Management - leads development of data retention policies, archival and purge processes, change management for reference data, data models, and metadata * Data Governance and Quality - supports corporate governance strategy, data profiling and score cards * Data Masking - masks data when required to reduce the risk of exposing sensitive data in queries or reports * Data Operations initiatives - focuses on efforts to shorten the systems development life cycle and provide continuous delivery, including statistical process controls, embedded data quality and governance, platform instrumentation, and enhanced self-service capabilities * Ensures proper implementation, education, and adherence to current guidelines and procedures * Collaborates with Cloud Engineering, Data Engineering, Data Governance Office, DevOps, Information Security, Infrastructure, and Integrations in the creation of policies, procedures, and use cases to provide solution enablement for data services consumers Installs and Configures Data Administration Tools: * Leads the installation, administration, and documentation of tools to support highly complex, enterprise-level data systems on various cloud-based and on-premise platforms * Monitors system metrics to ensure optimal performance and utilization of the systems. Provides 24x7 support for critical systems as an escalation contact during assigned on-call rotation * Evaluates the effectiveness of existing internal processes and applications and proposes solutions and opportunities for automation and audit controls * Develops, implements, and documents policies and procedures to ensure availability and business recovery of data systems * Leads team members efforts to identify and implement efficiency improvements on consumption-based platforms to contain costs * Leads complex projects to migrate legacy/on-premise data solutions to the cloud Technical Expertise and Training: * Participates in onboarding new team members and training team members * Maintains inventory lists of all database and software installations and provides recommendations to manager for license renewals * Partners with vendors on proof of concept used to determine best fit during vendor evaluation process Education & Experience: * Bachelor's degree, preferably in computer science or equivalent relevant experience * Eight years of data management administration experience or related experience * Experience executing data migrations from on-premise to cloud environments Knowledge, Skills & Abilities: * Thorough knowledge of current relational databases such as SQL or PostgreSQL * Advanced analytical skills related to database performance monitoring and troubleshooting * Strong knowledge of applicable scripting languages such as Bash, PowerShell, and Python * Thorough knowledge of Collibra, Informatica, Power BI, or Snowflake * Thorough knowledge of AWS cloud data services * Familiarity with administering data science platforms * Familiarity with administering data virtualization tools * Ability to work as part of a team and work collaboratively across departments and within all levels of the organization * Excellent verbal and written communication skills, including documentation * Excellent attention to detail, organizational and multi-tasking skills with the ability to adapt to changing priorities * Ability to work on a monthly on-call rotation * Ability to maintain confidentiality The hiring salary range for this position will vary based on geographic location, falling within either of the following: $101,677 - $145,733 or $112,094 - $160,670 A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit *********************** Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.
    $112.1k-160.7k yearly Auto-Apply 18d ago

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