Job Vacancy Lagos, Nigeria Position HMO Underwriter at Aspire HMO NG

Aspire HMO NG

Accounting, Auditing & Finance

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Company Description

Aspire HMO Limited is a National Health Maintenance Organization (HMO) licensed by the National Health Insurance Authority (NHIA) to provide innovative and quality-driven healthcare financing solutions across Nigeria. Aspire HMO is committed to redefining access to affordable healthcare through technology, operational excellence, and strong partnerships with providers and clients.

Role Description

This is an on-site, full-time role for a Health Maintenance Organization (HMO) Underwriter located in Gbagada, Lagos. The HMO Underwriter will evaluate and analyze insurance applications to determine coverage requirements and risk factors. The role involves preparing plan proposals, calculating premium rates, and ensuring compliance with company guidelines and regulatory standards. The position also involves collaborating with various teams to ensure efficient service delivery and maintaining accurate records for decision-making and reporting purposes.

Qualifications

• Strong analytical and problem-solving skills for evaluating risk and determining coverage requirements
• Excellent written and verbal communication skills for preparing proposals and collaborating with team members
• Attention to detail and experience with data assessment and record management
• Proficiency in using relevant software and tools for underwriting and reporting
• Familiarity with the health insurance sector, policies, and regulatory requirements
• Bachelor’s degree in Insurance, Actuarial Science, Business Administration, or a related field
• Prior experience in an underwriting or insurance-related role is preferred
• Ability to work efficiently under pressure and meet deadlines

Key Responsibilities

1. Underwriting & Risk Assessment

• Evaluate health insurance proposals (corporate, SME, micro, individual) in line with underwriting guidelines.
• Assess medical, demographic, utilisation, and claims risk factors.
• Determine appropriate pricing, benefit limits, exclusions, and loading where applicable.
• Support product development by providing underwriting input on new plans and micro-insurance products.

2. Pricing & Profitability

• Ensure pricing reflects risk exposure, benefit structure, and expected claims cost.
• Work with actuaries to validate assumptions and pricing models.
• Review renewal pricing and recommend adjustments based on claims experience.
• Protect target loss ratios and margin objectives.

3. Portfolio & Claims Monitoring

• Monitor portfolio performance, utilisation trends, and adverse selection risks.
• Flag high-risk groups and recommend corrective actions (benefit redesign, provider control, repricing).
• Support claims audits and investigations from an underwriting perspective.
• Collaborate with medical services and provider management teams to control cost escalation.

4. Policy Administration & Documentation

• Ensure accurate issuance of policy terms, schedules, endorsements, and exclusions.
• Maintain underwriting documentation and audit trails.
• Support compliance with NHIA and internal governance requirements.

5. Collaboration & Business Support

• Work closely with Sales, Business Development, Medical Services, and Finance teams.
• Support pre-sales meetings with underwriting insights when required.
• Provide turnaround support for large or complex accounts.

6. Compliance & Governance

• Ensure underwriting decisions comply with NHIA guidelines and internal policies.
• Participate in internal audits and regulatory reviews.
• Maintain confidentiality and ethical underwriting standards.

Key Performance Indicators (KPIs)

Financial & Risk KPIs

• Portfolio Loss Ratio (Actual vs Target)
• Pricing Accuracy (Variance between projected and actual claims cost)
• Renewal Margin Retention (%)
• Adverse Selection Rate (High-risk accounts detected early)

Operational KPIs

• Underwriting Turnaround Time (TAT)

Corporate quotes:

• 48–72 hours

Micro/SME plans:

• 24–48 hours
• Quote-to-Bind Conversion Rate (%)
• Error Rate in Underwriting Documentation (%)

Portfolio Management KPIs

• Claims Utilisation Variance vs Assumptions
• High-Cost Case Identification Rate
• Portfolio Repricing Effectiveness (%)

Compliance & Quality KPIs

• NHIA Compliance Score (Audit Findings)
• Policy Issuance Accuracy (%)
• Internal Audit Exceptions (Zero tolerance goal)

Collaboration & Business Support KPIs

• Sales Support Responsiveness Score
• Stakeholder Satisfaction (Internal Survey)
• Contribution to Product Improvements (Qualitative)

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