Manager of PBM Underwriting and Analytics

It's fun to work in a company where people truly BELIEVE in what they're doing!

We're committed to bringing passion and customer focus to the business.

                                                                                                                                                                                                                                                                   

The Manager of PBM Underwriting & Analytics is responsible for leading and overseeing the underwriting and analytical functions within the organization. This role involves managing a team of underwriting analysts to develop, implement, and refine strategies that ensure competitive pricing and profitability for pharmacy benefit programs. The position requires a deep understanding of pharmacy benefits, data analysis, and risk management.

                                                                                                                                                                                                                                                                   

Roles and Responsibilities:

• Implement & perform underwriting process for pharmacy benefit programs, including pricing strategies and risk assessment.

• Implement underwriting guidelines and procedures to ensure consistency and accuracy.

• Evaluate and approve complex underwriting decisions and proposals.

• Identify market trends, competitive threats, and opportunities for innovation.

• Drive initiatives to improve profitability and competitive positioning.

• Work closely with internal stakeholders, including finance, operations, and clinical teams, to ensure alignment on underwriting and analytical strategies.

• Develop strategic relationships with external stakeholders, including consultants, brokers, and other industry leaders

• Communicate findings and recommendations to senior leadership and other key stakeholders.

• Leverage advanced technology and data analytics tools to enhance underwriting processes and analytical capabilities.

• Stay updated with industry trends and technological advancements to continuously improve practices

                                                                                                                                                                                                                                                                   

Qualifications and Education Requirements:

• Bachelor’s degree in finance, Business Administration, Economics, or a related field. A master’s degree or similar/relevant experience. 

• Minimum of 6 years of experience in underwriting, analytics, or a related field within the healthcare or insurance industry, with at least 4 years in a leadership role. 

• Strong knowledge of pharmacy benefit management and the pharmaceutical industry. 

Skills & Competencies:

• Proven experience in data analysis and financial modeling. 

• Excellent leadership, communication, and interpersonal skills. 

• Proficiency in analytical software and tools (e.g., SQL, Excel, BI tools). 

• Ability to think strategically and drive results in a fast-paced environment 

Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. This is a largely sedentary role; however, some standing, walking, bending, and reaching may be required. Regularly operates in an office or home office setting which involves utilizing a computer, mouse, keyboard, and occasionally operates other standard office equipment, such as printer, copier, phone. Travel may be required by either car or airplane, or a combination of multiple modes of transportation.