Pharmacy Underwriter SeniorThe position can be anywhere in the states except for Colorado with a preference for candidates in our four Cambia states - OR, WA, ID or UT
The Pharmacy Underwriter Senior will support both new and renewal case specific ASC (self-insured) Pharmacy Benefit Management (PBM) pricing. The Pharmacy Underwriter will be responsible for quoting and rating proposals and renewal projections. Acts as a subject matter expert providing guidance to the Underwriting team for Pharmacy rating.
- Develop prospective and renewal pharmacy rates and terms (AWP discounts, rebates, and administrative fees) for group accounts in accordance with corporate and underwriting guidelines.
Collaborate with both internal and external colleagues in developing client-specific pharmacy pricing strategies.
- Work with proposal unit to ensure responses, including pertinent definitions and caveats, to all RFPs are complete and accurate.
- Support internal underwriting staff regarding pharmacy pricing questions.
- Effectively communicate pharmacy pricing decisions to other departments when necessary.
- Assist in the training process and mentoring of the Underwriting team related to pharmacy pricing.
- Analyze data from the PBM underwriting staff to produce market appropriate proposals.
- Contribute to the development of new pharmacy pricing formulas, methodologies, and guidelines.
- Prepare pharmacy reporting to provide for book of business insights.
- Assist with testing new pricing, underwriting and front-end systems as needed.
- Ensure the proper administration of underwriting and legislative guidelines for new and renewing groups.
- Achieve overall corporate financial goals by applying appropriate pharmacy pricing methodologies.
- Build winning financial offers that balance internal profitability and ensure competitiveness in the market.
Normally to be proficient in the competencies listed above:
- Prior experience with a major Pharmacy Benefit Manager, Health Plan, Pharmacy Brokerage or Consulting Practice.
Extensive knowledge of the health insurance and PBM industry and pricing practices.
- Demonstrated detailed knowledge of PBM pricing and concepts, including complex terms and conditions and their impact on the overall offer position.
- Successfully demonstrated skills and experience in underwriting and pricing of various funding options and products.
- Ability to build and maintain positive internal and external customer interactions.
- Demonstrated attainment of a high level of independent, consistent performance.
- Ability to organize, plan, prioritize and complete complex assignments with little or no supervision.
- Demonstrated high level of attention to detail and quality.
- Proven understanding of business, including finance, accounting, economics, and risk management.
- Demonstrated ability to read the marketplace and competitive environment.
- Ability to prioritize tasks and meet deadlines.
- Effective verbal and written communications.
- Strong team player with a customer service approach.
- Demonstrated technology proficiency, including Excel, Word, Teams and applicable software applications.
Pharmacy Underwriter Senior would have a Bachelor's degree in business, math, statistics or related discipline and a minimum of 5+ years related experience or an equivalent combination of education and experience.
This position includes 401(k), healthcare, paid time off, paid holidays, and more. For more information, please visit www.cambiahealth.com/careers/total-rewards
We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check are required.
If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com
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