Pharmacy Senior Underwriter

HCSC•Chicago, IL

1d•Hybrid

About The Position

At 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. 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. Relocation is NOT available; sponsorship will NOT be extended either now or in the future.

Requirements

Bachelor’s degree and three (3) years of consulting or underwriting experience in a group health insurance function.
Three (3) years of experience underwriting cases of lessor complexity OR demonstrated capability to meet required job responsibility.
Successfully demonstrated skills and experience in underwriting and pricing of various funding options and products and making sound decisions.
Strong mathematical skills for performing risk qualifications along with the ability to estimate for mathematical reasonableness.
Successfully demonstrated interpersonal skills establishing and maintaining business relationships.
Work management skills including the ability to multi-task, prioritize, and manage time and workload to meet deadlines with independent judgement and problem resolution skills.
Excellent verbal and written communication skills to conduct presentations and deliver on-the-job training.
PC proficiency to include MS Outlook, Word and PowerPoint with advanced Excel knowledge.
Successfully demonstrated negotiation skills and experience with presenting to external clients.
Extensive knowledge and skill applying state and federal legislation governing underwriting practices.
Financial analysis and underwriting skills.

Nice To Haves

Extensive experience-based knowledge of group medical products (ASOs, PBM), discount practices, stop loss and performance guarantees.
Strong knowledge of the PBM industry, consultants and industry trends.
Prior Pharmacy experience.
MBA or advanced degree.
Proficient experience utilizing Salesforce.

Responsibilities

Understand components of pharmacy pricing being able to articulate competitive differences of HCSC and competitor proposals to internal and external audiences.
Confidently model and forecast Pharmacy analyses in a clear and concise manner and present to Management on a frequent basis
Act as Underwriting Pharmacy Subject Matter Expert supporting department in leading completion of RX quotes and RFPs.
Ensure the retention and profitability of existing business through the calculation of appropriate renewal pricing.
Utilize all currently available information, models, and knowledge to accurately predict future claims and non-claims expenses for Renewals and RFPs.
Works closely with Management to provide alternate benefit plans, risk and/or funding arrangements.
Be responsible for contracting on case work
Update internal databases, etc.
Coordinate with Proposal Unit to ensure accurate and timely RFP completion.
Enforce adherence to Underwriting Guidelines and be responsible for approval of exceptions.
Identify areas for potential process improvements and work with management to help in their development and implementation
Participate in project work with other departments.
Maintain consistent high level of service to our sales representatives and clients with respect to renewal and proposal timeliness and accuracy.
Monitor PBM and pharmacy market trends, competitor pricing, and regulatory changes to inform underwriting strategy.