Pharmacy Senior Underwriter

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• Job Summary

•

BASIC FUNCTION HCSC

is looking for a dynamic individual to join its Underwriting team! This person will be responsible for quoting and rating proposals and renewal projections as well as approving cases within established guidelines. In this role, you'll lead pharmacy pricing and risk assessments, analyze utilization and trend drivers, and support the development of competitive, compliant proposals. You'll collaborate closely with actuarial, sales, clinical, and product teams, using data driven insights to guide decisions and improve outcomes. Success in this role requires strong analytical skills, attention to detail, and a solid understanding of pharmacy benefit design, claims, and market dynamics. This position is ideal for an experienced underwriting professional who enjoys working with complex pharmacy data, partnering cross functionally, and influencing pricing decisions for diverse employer and group clients.

NOTE:

the role is hybrid/flex and requires in-office visibility three days per week and working from home the other two days. Relocation is NOT available; sponsorship will NOT be extended either now or in the future.

• REQUIRED JOB QUALIFICATIONS

• + Bachelor's degree and three (3) years of consulting or underwriting experience in a group health insurance function. + Three (3) years of experience underwriting cases of lessor complexity
• OR•demonstrated capability to meet required job responsibility.

+ Successfully demonstrated skills and experience in underwriting and pricing of various funding options and products and making sound decisions. + Strong mathematical skills for performing risk qualifications along with the ability to estimate for mathematical reasonableness. + Successfully demonstrated interpersonal skills establishing and maintaining business relationships. + Work management skills including the ability to multi-task, prioritize, and manage time and workload to meet deadlines with independent judgement and problem resolution skills. + Excellent verbal and written communication skills to conduct presentations and deliver on-the-job training. + PC proficiency to include MS Outlook, Word and PowerPoint with advanced Excel knowledge. + Successfully demonstrated negotiation skills and experience with presenting to external clients. + Extensive knowledge and skill applying state and federal legislation governing underwriting practices. + Financial analysis and underwriting skills.

• PREFERRED JOB QUALIFICATIONS

• + Extensive experience-based knowledge of group medical products (ASOs, PBM), discount practices, stop loss and performance guarantees.. + Strong knowledge of the PBM industry, consultants and industry trends. + Prior Pharmacy experience. + MBA or advanced degree. + Proficient experience utilizing Salesforce.
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KEY FUNCTIONALITY/RESPONSIBILITIES

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• + Understand components of pharmacy pricing being able to articulate competitive differences of HCSC and competitor proposals to internal and external audiences.

+ Confidently model and forecast Pharmacy analyses in a clear and concise manner and present to Management on a frequent basis + Act as Underwriting Pharmacy Subject Matter Expert supporting department in leading completion of RX quotes and RFPs. + Ensure the retention and profitability of existing business through the calculation of appropriate renewal pricing. + Utilize all currently available information, models, and knowledge to accurately predict future claims and non-claims expenses for Renewals and RFPs. + Works closely with Management to provide alternate benefit plans, risk and/or funding arrangements. + Be responsible for contracting on case work + Update internal databases, etc. + Coordinate with Proposal Unit to ensure accurate and timely RFP completion. + Enforce adherence to Underwriting Guidelines and be responsible for approval of exceptions. + Identify areas for potential process improvements and work with management to help in their development and implementation + Participate in project work with other departments. + Maintain consistent high level of service to our sales representatives and clients with respect to renewal and proposal timeliness and accuracy. + Monitor PBM and pharmacy market trends, competitor pricing, and regulatory changes to inform underwriting strategy.

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• Pay Transparency Statement:

• At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work.

From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

• HCSC Employment Statement:

• We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

• Base Pay Range
• $61,500.00 - $136,100.00 Exact compensation may vary based on skills, experience, and location.
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• For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families.

As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only

• requests for accommodations in the application process
• will be returned.

All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.