Senior Pharmacy Benefits Underwriter & Strategist

EmpiRx Health, LLC.; United States; Hybrid; USD 120,000 - 210,000; Full time

Benefits offered by this job

Paid Time Off

401(k) program

Health Insurance including Dental & V4

Job summary

EmpiRx Health, LLC seeks a Senior Underwriter, Pharmacy Benefits to independently lead financial underwriting for complex RFPs, renewals, market checks, and BAFOs. You will translate claims, pricing, rebates, and clinical strategies into clear financial recommendations that protect client value and EmpiRx Health’s margin.

You will collaborate early across commercial, clinical, financial, contracting, implementation, and technology teams to ensure accuracy, build scenarios, and present

Qualifications

• Bachelor’s degree or equivalent in a related field.
• 5+ years of progressive experience in pharmacy-benefit, health-plan, healthcare, or related financial underwriting.
• Demonstrated hands-on experience with PBM or health-plan claims and pricing fundamentals.
• Experience with guarantee design or reconciliation and client P&L or margin decisions.
• Strong written and verbal communication skills for leadership presentations.
• Proven ability to lead complex RFPs, renewals, market checks, or pricing work with cross-functional teams.

Responsibilities

• Independently develop pricing and underwriting strategies for complex RFPs, renewals, market checks, and BAFOs.
• Interpret pharmacy claim fields, benefit rules, pricing benchmarks, discounts, fees, and channel economics.
• Validate census, claims, and RFP inputs; reconcile totals; and document assumptions and transformations.
• Build and explain base, upside, and downside scenarios; translate results into clear recommendations.
• Design, model, and reconcile discount, dispensing-fee, rebate, PMPM, and clinical-savings guarantees and integrate into client P&L and margin analysis.
• Identify high-cost risks and align modeled terms with contracts and implementation requirements.

Skills

Advanced Excel

Tableau

Domo

Salesforce

Communication skills

Education

Bachelor’s degree or equivalent

Master’s degree (Finance/Math/Statistics/Health Economics)

Tools

Tableau

Domo

Salesforce

Job description

EmpiRx Health, LLC seeks a Senior Underwriter, Pharmacy Benefits to independently lead financial underwriting for complex RFPs, renewals, market checks, and BAFOs. You will translate claims, pricing, rebates, and clinical strategies into clear financial recommendations that protect client value and EmpiRx Health’s margin.

You will collaborate early across commercial, clinical, financial, contracting, implementation, and technology teams to ensure accuracy, build scenarios, and present