Senior Underwriter, Pharmacy

HCSC•Richardson, TX

28d•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. BASIC FUNCTION 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.

Requirements

Bachelor's Degree OR 4 years of direct experience in managed care or network management involving independent work and judgment.
Plus 3 years project management experience including leading and planning projects.
Managed care/network management database experience including knowledge of information flow.
PC proficiency to include Word, Excel and PowerPoint.
Clear and concise verbal and written communication skills including interpersonal and presentation skills.
Self-starter, meet deadlines, manage multiple tasks/projects, work in a team environment.

Nice To Haves

Knowledge of state and federal network management legislation and regulations.

Responsibilities

Responsible for quoting and rating proposals and renewal projections as well as approving cases within established guidelines.
Lead pharmacy pricing and risk assessments.
Analyze utilization and trend drivers.
Support the development of competitive, compliant proposals.
Collaborate closely with actuarial, sales, clinical, and product teams, using data driven insights to guide decisions and improve outcomes.
Responsible for the management and maintenance of the following operational aspects of network programs: Project / Enhancements / Initiative planning and implementation, Cross functional departmental coordination, Program management and administration including data maintenance / processing, identifying providers for recruitment or education, research and resolution of issues, answering inquiries, Communications / Training including network management representative training, provider correspondence, webinars and related presentation material development, Results reporting and analysis coordination, System Testing.
Coordinate with HCSC plans in support of network programs.
Perform operational functions for specified network programs and serve as plan lead.
Coordinate with internal resources for implementation and operation tasks.
Establish relationships with appropriate HCSC representatives including technical areas, and coordinate operational activities with HCSC plans to promote synergies and consistency within HCSC.
Participate in BCA and/or external entities meetings when appropriate.
Identify and implement continuous improvement opportunities.