Director of Stop-Loss Underwriting (MGU)

About Tres Health

Tres Health is a rapidly growing, technology-driven healthcare benefits organization combining third-party administration, managing general underwriting, risk management, and proprietary technology.

The Director of Stop-Loss Underwriting will play a key role in expanding our MGU operations, strengthening carrier partnerships, driving underwriting profitability, and supporting the development of a scalable, automated underwriting platform.

Key Responsibilities

• Lead day-to-day MGU underwriting operations, including new business submissions, renewals, risk selection, pricing, and quote approvals.

• Establish and maintain underwriting guidelines, pricing methodologies, risk appetite, and delegated authority limits.

• Evaluate medical and pharmacy claims, large claimant exposure, utilization trends, and other risk factors to make informed underwriting decisions.

• Oversee underwriting for specific stop-loss, aggregate stop-loss, level-funded, and limited-benefit medical programs.

• Work closely with actuarial teams to develop pricing assumptions, monitor loss ratios, and ensure portfolio profitability.

• Manage relationships with carrier and reinsurance partners, ensuring compliance with underwriting agreements, reporting requirements, and risk-sharing arrangements.

• Monitor underwriting performance, portfolio concentration, claims development, and emerging risks.

• Collaborate with internal technology teams to improve proprietary underwriting systems, automate quoting processes, and streamline operational workflows.

• Partner with sales, distribution, claims, finance, and TPA operations to support business growth and product development.

• Lead and develop underwriting staff, establish performance standards, and maintain efficient underwriting turnaround times.

• Provide executive leadership with regular reporting on underwriting results, risk exposure, profitability, and portfolio performance.

Qualifications

• 7–10+ years of medical stop-loss underwriting experience, preferably within an MGU, insurance carrier, or reinsurance organization.

• Strong knowledge of specific and aggregate stop-loss, self-funded health plans, level-funded products, and medical claims analysis.

• Experience managing underwriting portfolios, pricing strategies, and risk selection.

• Familiarity with carrier-delegated underwriting authority, reinsurance agreements, and captive or quota-share arrangements.

• Strong understanding of loss ratios, claims trends, actuarial pricing methodologies, and portfolio profitability.

• Experience with underwriting technology, automated quoting platforms, and data analytics preferred.

• Proven leadership, analytical, communication, and decision-making skills.

• Ability to thrive in a fast-paced, entrepreneurial, and technology-driven environment.

Work Schedule & Remote Work

Full-time, remote position aligned with U.S. business hours. Flexibility required for critical project deadlines, cross-functional meetings, and occasional travel (0–10%) for team collaboration or vendor engagements.

Remote Work Requirements

• Dedicated home office with reliable, high-speed internet.

• Secure workspace aligned with HIPAA security standards (device encryption, secure Wi-Fi, screen privacy).

• Ability to effectively coordinate and lead projects in a fully remote environment.

Security, Privacy & Compliance

This position requires adherence to Tres Health’s security and privacy policies, including HIPAA compliance. All employees must complete security training and comply with access management protocols.

Physical Requirements

• Prolonged periods of sitting and working at a computer.

• Ability to communicate effectively through video, phone, and written platforms.

• Ability to effectively use computers, video conferencing tools, and other standard remote work technology.

• Visual and auditory capabilities suitable for remote work.

• Ability to occasionally lift up to 15 pounds.

Tres Health is committed to ADA compliance and will provide reasonable accommodations to individuals as needed.

Employment Status:
This position is governed by at-will employment, meaning either the employee or Tres Health may end the employment relationship at any time, with or without cause or notice, as permitted by law.

EEO & Reasonable Accommodation

Tres Health is an Equal Opportunity Employer. Qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other protected category. Tres Health provides reasonable accommodations to enable individuals with disabilities to perform the essential functions of the role. This description is not intended to list all duties or qualifications and may be updated at any time.