Senior Underwriter, Pharmacy
Occupations:
Insurance UnderwritersPharmacistsFinancial Risk SpecialistsPharmacy TechniciansFinancial ManagersIndustries:
Continuing Care Retirement Communities and Assisted Living Facilities for the ElderlyAdministration of Human Resource ProgramsBusiness Schools and Computer and Management TrainingVocational Rehabilitation ServicesInsurance and Employee Benefit FundsAt HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.Join HCSC and be part of a purpose-driven company that will invest in your professional development.BASIC FUNCTION HCSC is looking for a dynamic individual to join its Underwriting team! This person will be responsible for quoting and rating proposals and renewal projections as well as approving cases within established guidelines. In this role, you’ll lead pharmacy pricing and risk assessments, analyze utilization and trend drivers, and support the development of competitive, compliant proposals. You’ll collaborate closely with actuarial, sales, clinical, and product teams, using data driven insights to guide decisions and improve outcomes. Success in this role requires strong analytical skills, attention to detail, and a solid understanding of pharmacy benefit design, claims, and market dynamics. This position is ideal for an experienced underwriting professional who enjoys working with complex pharmacy data, partnering cross functionally, and influencing pricing decisions for diverse employer and group clients. NOTE: the role is hybrid/flex and requires in-office visibility three days per week and working from home the other two days.Required Job QualificationsBachelor's Degree OR 4 years of direct experience in managed care or network management involving independent work and judgment.Plus 3 years project management experience including leading and planning projects.Managed care/network management database experience including knowledge of information flow.PC proficiency to include Word, Excel and PowerPoint.Clear and concise verbal and written communication skills including interpersonal and presentation skills.Self- starter, meet deadlines, manage multiple tasks/projects, work in a team environmentPreferred Job QualificationsKnowledge of state and federal network management legislation and regulations.~ KEY FUNCTIONS ~Responsible for the management and maintenance of the following operational aspects of network programsProject / Enhancements / Initiative planning and implementationCross functional departmental coordinationProgram management and administration including data maintenance / processing, identifying providers for recruitment or education, research and resolution of issues, answering inquiriesCommunications / Training including network management representative training, provider correspondence, webinars and related presentation material developmentResults reporting and analysis coordinationSystem TestingCoordinate with HCSC plans in support of network programs.Perform operational functions for specified network programs and serve as plan lead. Coordinate with internal resources for implementation and operation tasks.Establish relationships with appropriate HCSC representatives including technical areas, and coordinate operational activities with HCSC plans to promote synergies and consistency within HCSC.Participate in BCA and/or external entities meetings when appropriate.Identify and implement continuous improvement opportunitiesCompensation: $45,900.00 - $102,100.00Exact compensation may vary based on skills, experience, and locationHCSC Employment StatementWe are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.To learn more about available benefits, please click https://careers.hcsc.com/totalrewards