The Manager of PBM Underwriting & Analytics is responsible for leading and overseeing the underwriting and analytical functions within the organization. This role involves managing a team of underwriting analysts to develop, implement, and refine strategies that ensure competitive pricing and profitability for pharmacy benefit programs. The position requires a deep understanding of pharmacy benefits, data analysis, and risk management.
Roles and Responsibilities:- Implement & perform underwriting process for pharmacy benefit programs, including pricing strategies and risk assessment.
- Implement underwriting guidelines and procedures to ensure consistency and accuracy.
- Evaluate and approve complex underwriting decisions and proposals.
- Identify market trends, competitive threats, and opportunities for innovation.
- Drive initiatives to improve profitability and competitive positioning.
- Work closely with internal stakeholders, including finance, operations, and clinical teams, to ensure alignment on underwriting and analytical strategies.
- Develop strategic relationships with external stakeholders, including consultants, brokers, and other industry leaders
- Communicate findings and recommendations to senior leadership and other key stakeholders.
- Leverage advanced technology and data analytics tools to enhance underwriting processes and analytical capabilities.
- Stay updated with industry trends and technological advancements to continuously improve practices
Qualifications and Education Requirements:- Bachelor's degree in finance, Business Administration, Economics, or a related field. A master's degree or similar/relevant experience.
- Minimum of 6 years of experience in underwriting, analytics, or a related field within the healthcare or insurance industry, with at least 4 years in a leadership role.
- Strong knowledge of pharmacy benefit management and the pharmaceutical industry.
Skills & Competencies:- Proven experience in data analysis and financial modeling.
- Excellent leadership, communication, and interpersonal skills.
- Proficiency in analytical software and tools (e.g., SQL, Excel, BI tools).
- Ability to think strategically and drive results in a fast-paced environment
Physical RequirementsThe physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. This is a largely sedentary role; however, some standing, walking, bending, and reaching may be required. Regularly operates in an office or home office setting which involves utilizing a computer, mouse, keyboard, and occasionally operates other standard office equipment, such as printer, copier, phone. Travel may be required by either car or airplane, or a combination of multiple modes of transportation.
