Manager, Pricing and Underwriting
Navitus Health Solutions / Lumicera Health Services
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Benefits offered by this job
Job summary
Navitus is seeking a Manager, Pricing and Underwriting to lead pricing, underwriting, and risk analysis for new and renewal business. You will develop pricing recommendations, maintain models, evaluate financial exposure, and support client profitability with data-driven decisions.
This remote-friendly role reports to the Director and includes coaching Supervisors and Analysts, participating in client meetings, and delivering accurate, compliant pricing results.
Qualifications
- Bachelor’s degree in Statistics, Mathematics, Finance, Actuarial Science, Economics, Risk Management or Business.
- 4+ years pricing/underwriting experience in PBM or related field.
- 2+ years of progressive leadership experience.
- Experience in PBM industry preferred.
- Experience with financial valuation models preferred.
- Adherence to compliance program objectives.
Responsibilities
- Manage pricing and underwriting functions for new and renewal business, pricing requests, RFP responses and client analyses.
- Lead, coach and train supervisors and analysts to ensure accurate, timely pricing and risk deliverables.
- Oversee interpretation of claims utilization, network pricing, rebates, and trend to inform pricing decisions.
- Develop and maintain pricing, risk, and client profitability models for prospective and current opportunities.
- Evaluate pricing risk and value of client relationships to align with financial and strategic goals.
- Maintain underwriting guidelines, pricing standards, and quality assurance for pricing decisions.
- Participate in client meetings and presentations communicating pricing approach and financial risk.
- Support leadership reporting on pricing, profitability, risk exposure and performance metrics.
- Identify process improvements and training opportunities to increase accuracy and value.
- Mentor and develop team members to ensure a pipeline of future leaders.
- Perform other duties as assigned.
Skills
Education
Job description
Navitus
Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other.
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Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities.
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We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.
USD $96,481.24 - USD $118,382.22 /Yr.
10.00 - Pharm, Supvr, AsMgr, SrCSEII, PrgMgr, SrPrgMgr, SrProdMgr
M-F 8am to 5pm
ATTENTION: Navitus is only able to offer remote work to residents of Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington DC, Wisconsin.
Due to growth, we are adding a Manager, Pricing and Underwriting to our team.
The Manager, Pricing and Underwriting supports and manages core functions across the full scope of pricing, underwriting, and risk analysis. This position reports to the Director, Pricing and Underwriting and will provide leadership to Supervisors and Analysts. The Manager is responsible for developing pricing recommendations, evaluating financial risk, maintaining underwriting models, and supporting pricing decisions for new business, renewal business, client retention, and RFP opportunities.
Is this you? Find out more below!
How do I make an impact on my team?
- Manage pricing and underwriting functions for new business, renewal business, client pricing requests, RFP responses, finalist presentations, and ad hoc financial analyses.
- Lead, coach, and train supervisors, and analysts, to support accurate, timely, and consistent pricing, underwriting, and risk analysis deliverables.
- Oversee the interpretation and application of claims utilization, network pricing, pharmaceutical rebate pricing, administrative fee pricing, trend, government services impacts, client profitability, and other relevant data to inform pricing recommendations and financial decisions.
- Direct the development, maintenance, and use of pricing models, risk evaluation models, and client profitability models used to evaluate prospective and current client opportunities.
- Evaluate pricing risk, financial guarantee exposure, and value derived from client relationships to support balanced recommendations aligned with Navitus’ financial, strategic, and client retention objectives.
- Maintain and apply underwriting guidelines, pricing standards, approval processes, policies, procedures, work instructions, and quality assurance practices to support consistent, compliant, and well-documented pricing decisions.
- Participate in client-facing meetings, finalist presentations, and internal strategy discussions by communicating pricing approach, financial risk, and business value to technical and non-technical audiences.
- Support periodic leadership reporting on pricing, underwriting, client profitability, business value, risk exposure, actual-to-expected performance, and related performance metrics.
- Identify and implement process improvements, model enhancements, reporting improvements, training opportunities, and quality assurance practices to increase accuracy, efficiency, consistency, and business value.
- Establish, mentor, and develop team members through coaching, feedback, and career planning, ensuring a pipeline of future leaders and a culture of accountability and growth.
- Other duties as assigned.
What our team expects from you?
- Bachelor’s degree, preferably in Statistics, Mathematics, Finance, Actuarial Science, Economics, Risk Management, or Business, required.
- 4+ years of pricing and/or underwriting experience in pharmacy benefit management, managed care, or adjacent setting required.
- 2+ years of progressive leadership experience, which may include leading individual contributors or teams, or equivalent leadership experience such as coaching, mentoring, or leading complex initiatives or projects, required.
- Experience working in the pharmacy benefit management industry preferred.
- Experience using financial valuation models and analyzing results preferred.
- Participate in, adhere to, and support compliance program objectives.
- The ability to consistently interact cooperatively and respectfully with other employees.
What can you expect from Navitus?
- Top of the industry benefits for Health, Dental, and Vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401K company match of up to 5% - No vesting requirement
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan and Professional Membership assistance
- Referral Bonus Program – up to $750!
Remote
US
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