Director Health Plan Underwriting - REMOTE
About The Position
The Director of Health Plan Underwriting is responsible for leading the Underwriting team responsible for providing information, analyses, and RFP support for the organization to develop recommendations for pricing terms and structure. This position is responsible for providing overall direction and leadership to the underwriting teams, which includes oversight of health plan strategies for all lines of business. The Director is also responsible for serving as an expert consultant on matters pertaining to underwriting, performance guarantees, margin, and other financial considerations that impacts a PBM offering.
Requirements
- Bachelor's degree in Mathematics, Accounting, Finance or related are of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
- 8 years of related experience and/or training
- 5 years of leadership/people management experience
- Must be eligible to work in the United States without need for work visa or residency sponsorship
- In-depth knowledge of mathematical applications used in underwriting function 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
- Exceptional communication skills; ability to distill complex material into easy to understand presentations, effectively respond to questions and engage a variety of audiences
- Strong team player with a customer service approach
- Ability to effectively communicate with Senior Leadership Team and Executive Leadership Team. Presents recommendations to Executive Leadership on new pricing methodologies and follows through on execution of key strategies
- Ability to persuade and influence executive leadership at Prime, current Blue and prospective Blue plans with key initiatives to support margin and growth objectives for the self-insured pharmacy market
- Ability to negotiate with difficult external audiences and partners to support Prime and Blue plan objectives
Nice To Haves
- 3 years of experience as an Underwriting Manager with PBM experience
Responsibilities
- Provides both strategic direction and day to day guidance to a team of underwriters and managers, to maintain expert underwriting support and meet the needs of the organization
- Works with client engagement teams to develop, drive, and execute pricing and margin strategies
- Oversees and coordinates workflow for the underwriting team
- Works with proposal unit to ensure responses, including pertinent definitions and caveats, for the financial responses to all RFPs are complete and accurate
- Consults with Legal and Client Engagement to ensure, contractual deal terms, caveats, and other pertinent information is accurate and supports the deal as underwritten
- Assists with client contract negotiations as needed
- Engages in client and external consultant engagements to demonstrate Prime's value proposition
- Responsible for ensuring standard operating procedures are adhered to and that all bids are properly tracked and documented
- Collaborate with management on staffing plans, productivity metrics and initiatives to improve efficiencies within the department
- Other duties as assigned
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What This Job Offers
Job Type
Full-time
Career Level
Director
Number of Employees
501-1,000 employees
