Underwriter - Pharmacy

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

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.

Job 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.

Job Qualifications

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
• 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.

Applying for this job indicates your acknowledgement and understanding of the following statements:

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

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.