Pharmacy Underwriter IV

Blue Cross Blue Shield of Massachusetts • Boston, MA

110d • $106,830 - $130,570

About The Position

Ready to help us transform healthcare? Bring your true colors to blue. Underwriting is instrumental to securing the financial wellbeing of insurance companies. At Blue Cross Blue Shield of Massachusetts, Underwriters are valued partners in contributing to the organization’s success by influencing business segments such as Marketing, Product Portfolio, Infrastructure Planning and Network Planning. In addition to account underwriting responsibilities, the Underwriter / Pharmacy Specialist will have opportunities to participate in project teams working to enhance both operational processes and strategic business initiatives. Working on a team with experienced Underwriters as well as peers, this is a great opportunity to deepen skills, contribute to a mission critical business function and develop your career. This role is eligible for our Flex persona.

Requirements

• Undergraduate or Masters Degree is required.
• Minimum of seven years Pharmacy or related experience is required.
• PBM experience is a plus.
• Must have an extensive knowledge of Pharmacy programs, rebate optimization and modeling.
• Must possess superior oral and written communication skills with the ability to present information to a variety of audiences.
• A creative problem solving ability is required.
• Ability to work in a fast paced, high-volume environment.
• Must be familiar with Microsoft Office.

Responsibilities

• Act as Liaison between Underwriting and Pharmacy departments representing Underwriting in strategy and implementation efforts.
• Act as Liaison between Underwriting Department and our PBM developing working relationships that drive partnership and accountability.
• Act as Underwriting Pharmacy SME supporting department in leading completion of RX quotes and RFPs.
• Coordinate with Proposal Unit to ensure accurate and timely RFP completion.
• Consult with Actuarial Team to develop and implement ASC Pharmacy Pricing Strategies.
• Master complex components of pharmacy pricing being able to articulate competitive differences of BCBSMA and competitor proposals to internal and external audiences.
• Master utilization of Rx tracking and settlement processes and report results to leadership.
• Enforce adherence to Underwriting Guidelines and be responsible for approval of exceptions.
• Monitor and report on the profitability and persistency of the assigned book of business.
• Maintain consistent high level of service to our sales representatives and clients with respect to renewal and proposal timeliness and accuracy.
• Participate in the development of new products and rating methodologies.
• Meet and present and consult with colleagues in Sales and externally with senior client management and/or their consultant.
• Confidently model and forecast complex analyses in a clear and concise manner and present to senior/executive levels of leadership (internally and externally) on a frequent basis.
• Identify areas for potential process improvement and take ownership/participate in their development and implementation across the department.

Benefits

• Paid time off
• Medical/dental/vision insurance
• 401(k)
• Suite of well-being benefits

What This Job Offers

• Job Type: Full-time
• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees