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The Emcap Program Manager develops and manages trusted relationships with assigned captive programs, functioning as primary liaison, supporting the implementation of new programs and delivering reporting, analysis and making recommendations of best practices and health risk management approaches to mitigate financial exposure. Duties and responsibilities include but are not limited to:
- Developing and managing trusted relationships with assigned captive programs, including effectively interfacing with C-Suite and executive level business relationships at the policyholder, TPA, Broker, Captive and a variety of third parties.
- Functioning as primary liaison with Captive Manager and overseeing necessary captive deliverables to ensure timely cession reporting and member/consultant support.
- Coordinating and preparing monthly, quarterly and annual loss reporting packages, quarterly conference calls, and 1:1 report introduction calls, as well as supporting and presentating at regional and annual program meetings
- Developing and managing communication of results and performance of assigned captive programs to internal and external parties, including analysis of historical performance and interpretation of loss performance.
- Developing and managing surveys and voting for assigned captive programs.
- Working with distribution channel and captive members in development and implementation of risk management strategies and education of potential health risk management solutions/vendors.
- Supporting the launch of new captive programs including establishing the cession reporting, coordinating calls and logistics with Program Sponsor/Captive Manager to ensure a smooth implementation.
- Developing documentation/recommendation of processes and procedures to support efficiency and growth targets for the captive division.
- Effectively liaising with various operating areas including premium accounting, finance, and clinical team on behalf of policyholders and consultant brokers to ensure understanding of claims handling, premium processes, policy provisions/endorsements and understanding internal health risk management services.
- Managing vendor relationships to maintain smooth coordination between the parties (TPAs, disease management, broker, captive, members, etc.)
- In collaboration with AVP, overseeing the activities of account management team assigned to programs, including training, development, and input on performance reviews to ensure appropriate coordination of information and resources to achieve customer service standards. At times providing back-up and support in interfacing with broker, policyholder and TPAs.
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Berkley Accident and Health is seeking a full time Underwriting Associate in our Hamilton Square, NJ office. Essential duties and responsibilities of this entry level role in our Underwriting team include but are not limited to:
- Setting up folders in a team shared drive for all information received for new submissions
- Running census data in Excel spreadsheets for each submission
- Logging submission in David Young system including benefits, reinsurance terms, and census
- Communicating with Sales Reps and Underwriters to ensure all information is complete and accurate
- Providing other administrative support to the team as needed
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The Stop Loss Claims Analyst performs a complete quality review and evaluation of all claim submissions received and logged in the David Young Claim System to determine whether the amount requested is eligible for reimbursement under the Stop Loss Policy in force. Duties and responsibilities include but are not limited to:
- Process an average of 5 to 7 claims per day.
- Maintain a processing accuracy of 99% or better.
- Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim.
- Review and adjudicate claims within approved authority limits.
- Maintain assigned claim block and assist other team members while meeting departmental guidelines.
- Elevates issues to next level of supervision, as appropriate.
- Exhibit good organizational, oral communication and interpersonal skills while working with internal and external customers.
- Document rationale of claim decisions based on review of the contractual provisions, plan specifications and the analysis of medical records, etc.
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Berkley Accident and Health is seeking a full time Regional Sales Manager to develop profitable business initiatives in an assigned territory (N. Carolina, S. Carolina, Tennessee, Virginia and W.Virginia) by devising a detailed, focused sales plan to identify target markets needed to hit sales goals, directing distribution of Employer Stop Loss and Corporate Products in assigned region and any unassigned states through network of preferred producers, and creating new distribution outlets and facilitating marketing efforts to utilize alternative distribution methods, i.e. cross marketing through the Berkley family of companies, e-mail blasts and newsletters, and attendance at industry events and seminars. Duties and responsibilities include but are not limited to:
- Generate and facilitate high monthly volume of pre-qualified submissions for all authorized Berkley Accident and Health products
- Provide regular feedback to Home Office on successes and failures in the quote process to allow for adjustments and improve close ratio.
- Provide monthly updates on pipeline, current and future activity
- Continue to expand product education and develop cross-selling opportunities within territory
- Make a minimum of 12 calls per day to prospective customers to build a continuous chain of callbacks, prospects and new opportunities every week, facilitated by a minimum of 3-5 new face to face meetings per week.
- Be a proactive listener with customers by identifying needs and collaborating with Home Office to derive innovative solutions.
Office location is flexible and can be in any state in the Region
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The Special Risk Division of Berkley Accident and Health offers customizable accident insurance solutions that may help groups, individuals and families minimize the financial impact that can result from a covered accident. We are seeking a Products & Compliance Analyst to join our team and offer flexibility with regard to work/office location. Duties and responsibilities include but are not limited to:
- Assist with Product Development of a vast array of group, blanket and individual accident products, supplemental health products, specified disease products and other Accident & Health products
- Prepare and submit form and rate filings via SERFF and I-File after thorough compliance review of relevant legislation and regulatory updates
- Work collaboratively with Underwriting and Actuarial, as applicable, to promptly address Insurance Department inquiries, negotiate regulatory approval in the required jurisdictions and prepare detailed instructions for products’ use upon approval
- Develop and maintain successful and productive relationships with state insurance department personnel to effectively resolve filing issues while furthering company interests
- Manage filing status for all products and update all applicable status charts and other internal documents
- Maintain a database of product filings including the due dates and status of the filings, prepare reports on the status of filing projects for management and maintain form, rate and rule manuals for implementation
- Prepare thorough and clear communication to IT Department regarding any changes to currently automated forms and/or additions to automated system necessitated by each new approval. Must provide proper print rules, work with programmers, testing of output and sign-off prior to release to the business unit
- Assist with efforts to automate all Accident & Health policy forms including reviewing and commenting on policy specifications, inventory of approved state-specific text and rules, clarification of issue instructions, creation of test cases, participation in policy fulfillment testing, creation and maintenance of tracking logs, quality assurance, and other related tasks
- Perform compliance research and other projects as requested
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As a strategic partner, the Assistant Vice President works with the Vice President of Human Resources (VP HR) and Operating Unit Leadership to align and support the VP HR with the execution of the talent strategy and operating unity strategic initiatives. This role works closely with Leadership and Group HR to consult, provide advice and guidance as it relates to talent-related activities including but not limited to: recruitment and selection, staff retention, performance management, talent development, compensation planning and employee relations.
The Assistant Vice President fulfills the primary responsibilities of the role by executing the following duties and tasks:
- Consults and counsels with leaders on performance management, talent development, salary administration, succession planning, recognition, training gaps, employee relations, employee conduct, etc.
- Guides and coaches leaders through actions related to formal disciplinary procedures, jointly determines appropriate course of actions; reviews and provides suggestions for performance improvement plans; and ensures legal compliance with aid of VP HR and/or legal counsel when necessary
- Proactively identifies areas for process improvement, innovation, and opportunities for efficiency and synergy
- Partners with management to improve employee engagement and increase productivity and retention, this includes coordination of community or company events, e.g.
- Confers with leaders to identify staffing needs, job specifications, job duties, qualifications, skills and competencies
- Partners with recruiting on internal and external recruitment efforts for all positions
- Partners with hiring managers to ensure proper department on-boarding tasks including: 30/60/90 day reviews, survey analysis, etc.
- Partners with the hiring manager to ensure required timely completion of new hire I-9’s; and finding alternative sources to complete new hire’s I-9 for off-site/remote/employees. Updating I-9 verifications in HireRight as required.
- Assists in the development and delivery of management and/or employee training sessions related to strategic initiatives, performance management, employee engagement, succession planning, etc.
- Actively researches, creatively designs and implements effective methods to educate, enhance performance and recognize performance; advising and collaborating on the development and administration of recognition programs with Group HR
- May lead or participate in special and/or cross-functional project teams related to Company and/or TCR strategic initiatives
- Identifies, evaluates and resolves employee relations issues such as employee complaints, harassment allegations and civil rights complaints
- Conducts, Analyzes and reports on trends related to employee relations activities; Reviews exit interviews to analyze reasons for separation and to identify trends
- Assists employees with developing personal strategies or action plans related to the workplace, e.g., career development, performance improvement, peer/manager conflict, communication, etc.
- Administers initial and ongoing Visa and Immigration requirements
- Administers one – time – payments in Workday including: Sign On Bonus/Severance/Tuition Reimbursements
- Additional duties as assigned
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Berkley Accident and Health is seeking a full time Underwriter for its Managed Care segment. This position will solicit, write and retain a profitable book of Managed Care/Reinsurance business. Requiring extensive underwriting analysis and sound judgment, this role will be responsible for contributing to the achievement of Berkley Accident & Health’s financial plans by meeting established premium growth and profitability goals.
Managed Care Underwriter Essential duties include:
- Assess risk to ensure that the risk meets established underwriting criteria
- Evaluate, price and propose rates based on established underwriting guidelines while meeting profitability standards set by Management.
- Manage assigned workload to meet productivity and time service standards.
- Maintain quote logs and ensure that appropriate action is taken within the requested due date.
- Develop and maintain successful relationships with target sources.
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Berkley Accident and Health is seeking a full time Stop Loss Underwriter for our Group Captive division. This position will write and retain profitable accounts that require underwriting experience, with an analytic approach to spread risk. This role will contribute to the achievement of Berkley’s financial plans by meeting premium growth and profitability of assigned book of business.
Stop Loss Underwriter, Captives Segment – Essential duties include:
• Underwrites and proposes financial structure on accounts from 50 – 400 employees within delegated authorities that are specific to position.
• Responsible for constant analysis and development of underwriting and business guidelines
• Develops and maintains successful relationships with target sources and assigned programs
• Responsible for ensuring profitability at both the single employer and group captive level
• Manages an assigned volume of case and program activity for both new and renewal policies
• Works with Supervisor and Actuary to revise and develop group captive tools to improve efficiencies in underwriting process.
• Communicates effectively with various team members within Captive Division