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Senior Underwriter - Health Plan - Remote

Role overview

Qualifications

  • Bachelor's degree in mathematics, accounting, or related area of study
  • 5 years of related work experience in Finance or Accounting
  • In-depth knowledge of mathematical applications used in underwriting function
  • Proficient in MS Office applications, particularly Excel, Word and PowerPoint

Responsibilities

  • Evaluates the utilization and financial experience of customers and prospects
  • Performs claims re-pricing analyses for complex external claims data
  • Provides support to Sales, Marketing and Client Engagement
  • Consults with other departments such as Legal, IT, HPS and Marketing

Key facts

Other skills

  • Microsoft Office
  • Communication

About the company

Prime Therapeutics logo

Prime Therapeutics

Pharmacy Benefit Management (PBM)

Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 24 years. In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 28+ million members throughout the US. In addition to core PBM services, we work closely with our clients to implement the right benefit design, clinical and specialty programs, formulary and networks. A few key products: • NetResults™ • Specialty Drug Management • Best in Care™ • GuidedHealth® • Advanced Fraud, Waste and Abuse: Member and Prescriber Investigations • Prime Analytics™ • CareCentered Contracting™Controlled Substance Management Program Join us! Prime is always looking for smart, purposeful people to join our team. We’re growing fast which means there are plenty of opportunities to advance and grow in your career. At the same time, Prime supports flexibility and offers generous PTO so you can enjoy an enviable work/life balance. We’re a privately held company -big enough to make a difference and small enough for you to have an impact. Prime’s recruiting team will only contact you via phone call or through a corporate email address. Do not respond to suspicious emails or social media messages. If you have questions or are skeptical about any follow-up communications, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.

Company details

Company typeLarge
IndustryPharmacy Benefit Management (PBM)
Company size1001 - 5000

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Job description

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.

Job Posting Title

Senior Underwriter - Health Plan - Remote

Job Description

The Senior Underwriter is responsible for achieving profit, growth, service and expense objectives through the financial analysis and pricing of Prime's book of business. Under minimal supervision, the Senior Underwriter serves as an expert consultant on matters pertaining to underwriting, performance guarantees and other financial considerations. Provides underwriting services to determine pricing and monitors accounts to ensure they remain on a profitable basis. Maintains and applies knowledge of pricing strategies in the PBM industry. Maintains a positive working relationship with Sales, Marketing and Client Engagement and other key business owners within Prime.

Responsibilities

  • Evaluates the utilization and financial experience of customers and prospects, many of which are very complex
  • Performs claims re-pricing analyses for the most complex external claims data
  • Provides support to Sales, Marketing and Client Engagement, assisting in the development of client presentations and negotiations pertaining to pricing and guarantees
  • Consults with other departments such as Legal, IT, HPS and Marketing, and participates in meetings as required on issues that have financial implications
  • Other duties as assigned

Minimum Qualifications

  • Bachelor's degree in mathematics, accounting, or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
  • 5 years of related work experience in Finance or Accounting
  • Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

  • Prior work experience in the PBM and/or healthcare industry
  • In-depth knowledge of mathematical applications used in underwriting function is required, including the ability to calculate figures such as discounts, proportions and percentages, as well as the ability to apply basic concepts of business mathematics and algebra in underwriting problems
  • Ability to effectively present information and respond to questions in one-on-one or small group situations
  • Proficient in MS Office applications, particularly Excel, Word and PowerPoint

Preferred Qualifications

  • 2 years as a Senior Underwriter or Benefits Consultant
  • Proficient with Salesforce.com

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures

Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.

Potential pay for this position ranges from $81,000.00 - $138,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
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