Senior Underwriter, Pharmacy Benefits (Remote/Hybrid)

EmpiRx Health, LLC.; Montvale (NJ); Hybrid; USD 120,000 - 180,000; Full time

Benefits offered by this job

Health Insurance

401(k) program

Paid Time Off

Job summary

EmpiRx Health in Montvale, NJ is hiring a Senior Underwriter, Pharmacy Benefits. The role leads financial underwriting for complex RFPs, renewals, and BAFOs, translating pharmacy data into clear financial recommendations and protecting client value and company margin.

The position requires strong Excel modeling, pricing design, and collaboration across commercial, clinical, financial, contracting, and implementation teams in a hybrid work setting.

Qualifications

• Bachelor's degree or equivalent with 5+ years in PBM/healthcare or related financial underwriting
• Hands-on experience with PBM or health-plan claims and pricing fundamentals
• Strong Excel skills and ability to build and explain financial models
• Experience with guarantee design, reconciliation, and client P&L decisions
• Able to present assumptions and recommendations to leadership

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, rebates, and margins.
• Validate inputs, reconcile totals, and document assumptions.
• Build and explain base, upside, and downside scenarios and translate results into recommendations.
• Design and reconcile pricing guarantees, including true-ups and exclusions.
• Integrate claims economics, rebates, and fees into client P&L and margin analysis.
• Lead cross-functional collaboration with Sales, Clinical, Contracting, and Implementation.

Skills

Excel advanced

Financial modeling

Data analysis

Communication

Education

Bachelor's degree in Finance/Economics/Math

Master's degree preferred

Tools

Tableau

Salesforce

Financial modeling tools

Job description

EmpiRx Health in Montvale, NJ is hiring a Senior Underwriter, Pharmacy Benefits. The role leads financial underwriting for complex RFPs, renewals, and BAFOs, translating pharmacy data into clear financial recommendations and protecting client value and company margin.

The position requires strong Excel modeling, pricing design, and collaboration across commercial, clinical, financial, contracting, and implementation teams in a hybrid work setting.