Pharmacy Underwriter - Risk & Pricing (Remote)

BlueCross BlueShield of Tennessee; United States; On-site; USD 80,000 - 110,000; Full time

Job summary

BlueCross BlueShield of Tennessee is seeking an Underwriter-Pharmacy within Commercial Operations to evaluate risk, set pricing, and manage pharmacy claims costs, with an emphasis on accuracy and financial stability.

As part of a cross-functional team, you’ll analyze data, communicate findings, and support sales and actuarial projects while using AI-enabled tools responsibly in line with policy.

Qualifications

• Bachelor's degree in Mathematics, Finance, Accounting or related field or equivalent work experience.
• 2 years of Stop Loss UWg, Financial UWg, Actuarial, or Fin. Mgmt. experience

Responsibilities

• Collecting information, contacting sales, account managers, agents, and other parties as appropriate to clarify and correct inconsistent, incorrect or missing group health application information.
• Perform risk appraisals for group health insurance prospect and renewals and associated underwriting documentation; evaluating and classifying group risk to determine acceptability, coverage and pricing.
• Calculating and negotiating rates and premium charges for group health insurance using approved formulas and tables
• Corresponding with sales, account managers, agents, and other parties regarding group health insurance products, features, and pricing.
• Assisting the on-going maintenance and enforcement of underwriting guidelines as well as providing underwriting expertise to projects in support of sales, marketing, membership and billing, legal or actuarial organizations.

Skills

Oral communication

Written communication

Analytical skills

Planning

Interpersonal skills

Organizational skills

Research skills

Independent worker

Team collaboration

Negotiation

Presentation skills

Facilitation skills

Education

Bachelor's degree in Mathematics, Finance, Accounting or related field

Tools

Microsoft Office

Job description

BlueCross BlueShield of Tennessee is seeking an Underwriter-Pharmacy within Commercial Operations to evaluate risk, set pricing, and manage pharmacy claims costs, with an emphasis on accuracy and financial stability.

As part of a cross-functional team, you’ll analyze data, communicate findings, and support sales and actuarial projects while using AI-enabled tools responsibly in line with policy.