Underwriter - Pharmacy

BlueCross BlueShield of Tennessee, Inc.; Chattanooga (TN); Remote; USD 90,000 - 130,000; Full time

Job summary

BCBST BlueCross BlueShield of Tennessee, Inc. seeks an Underwriter-Pharmacy in its Commercial Operations Division to manage pricing, contracts, and configuration for pharmacy claims, assessing risk and financial impact.

Requires a Bachelor's in Math/Finance/Accounting or related field and 2+ years in underwriting or actuarial roles; strong communication, Excel proficiency, and cross-functional collaboration.

Qualifications

• Bachelor's degree in Mathematics, Finance, Accounting or related field.
• 2+ years in Stop Loss UWg, Financial UWg, Actuarial, or Fin. Mgmt.
• Excellent oral and written communication skills.
• Proficient in Microsoft Office (Outlook, Word, Excel, PowerPoint).
• Strong analytical, planning, interpersonal, organizational and research skills.
• Ability to work independently or in a team with accountability.
• Effective negotiation, presentation, and facilitation skills.

Responsibilities

• Collect information and coordinate with sales, account managers, and agents to correct data.
• Perform risk appraisals for group health prospects and renewals.
• Evaluate and classify group risk to determine acceptability and pricing.
• Calculate and negotiate rates and premium charges for group health insurance.
• Communicate with sales, account managers, and other parties about products and pricing.
• Support underwriting guidelines and provide underwriting expertise to projects.

Skills

Communication

Microsoft Office

Analytical skills

Independent work

Negotiation

Presentation

Teamwork

Education

Bachelor's in Math/Finance/Accounting

Tools

Microsoft Office

Job description

We're hiring an Underwriter-Pharmacy in our Commercial Operations Division! The Underwriter - Pharmacy is part of a team within Underwriting that works on all things pharmacy related: pricing, contracts, configuration, and more. We evaluate critical information to assess risk and provide financial stability related to a client’s pharmacy claim costs, incorporating any known marketplace impacts within the analytics. Pharmacy is a fast-paced, ever-changing environment, requiring critical thinking, flexibility, problem solving, accuracy, quality, and making sound underwriting decisions. You'll be successful in this role if you are a driven, adaptable self-starter who is very detail-oriented, excels at math, and able to comprehend complex information. We are searching for someone who can balance detailed analysis with strategic thinking, as candidates must be comfortable both digging into underlying data and communicating findings at a high level. Success in this position depends on strong organizational skills, the ability to manage multiple priorities, and a willingness to collaborate with cross-functional teams. We foster a culture where innovation is encouraged. That includes using AI enabled tools responsibly to support everyday work - guided by proven workflows, templates, and policies.

Notes: This remote position offers a Monday - Friday 8-hour work schedule primarily between the hours of 8:00 a.m. - 5:00 p.m. ET. During our peak season from March to September, additional hours may be required, including weekends. Location preference for candidates who reside within a 2-hour drive of our Chattanooga, TN headquarters. Sponsorship is not available for this role.

• 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.

• Education: Bachelors Degree in Mathematics, Finance, Accounting or related field or equivalent work experience.
• Experience: 2 Years - Stop Loss UWg, Financial UWg, Actuarial, or Fin. Mgmt. experience.
• Skills\Certifications: Excellent oral and written communication skills.
• Skills\Certifications: Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint).
• Effective analytical, planning, interpersonal, organizational and research skills with the ability to handle multiple projects.
• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
• Effective negotiation, presentation, and facilitation skills.

Number of Openings Available 1

Worker Type: Employee

Company: BCBST BlueCross BlueShield of Tennessee, Inc.

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices

As Tennessee's largest health benefit plan company, we've been helping Tennesseans find their own unique paths to good health since 1945. More than that, we're your neighbors and friends - fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow.

At BCBST, we empower our employees to thrive both independently and collaboratively, creating a collective impact on the lives of our members. We seek talented individuals who excel in a team environment, share responsibility, and embrace accountability. We're also seeking candidates who are proficient in the Microsoft Office suite, including Microsoft Teams, organized, and capable of managing multiple assignments or projects simultaneously. Additional, strong interpersonal abilities along with strong oral and written communication skills are important across all roles at BCBST. We foster a culture where innovation is encouraged. That includes using AI enabled tools responsibly to support everyday work - guided by proven workflows, templates, and policies. As roles become more advanced, we expect employees to leverage AI more broadly to transform how we serve members.

BCBST is a remote-first organization with many employees working primarily from their homes. Each position within the company is classified as either fully remote, partially remote, or office based. BCBST hires employees for remote positions from across the U.S. with the exception of the following states: California, Massachusetts, New Hampshire, New Jersey, and New York. Applicants living in these states may move to an approved state prior to starting a position with BCBST at their own expense. If the position requires the individual to reside in Chattanooga, TN, they may be eligible for relocation assistance.