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Cambia Health Solutions Pharmacy Underwriter Lead - R-746_2 in LEWISTON, Idaho

This job was posted by https://idahoworks.gov : For more information, please see: https://idahoworks.gov/ada/r/jobs/1501559 &&&b&Pharmacy Underwriter Lead&/b&&&&&&b&The position can be anywhere in the states with a preference for candidates in our four Cambia states - OR, WA, ID, or UT&/b&&&&br&&br&&&&&&br&The Pharmacy Underwriter Lead will support both new and renewal case specific ASC (self-insured) Pharmacy Benefit Management (PBM) pricing. The Pharmacy Underwriter will be responsible for quoting and rating proposals and renewal projections. Acts as a subject matter expert providing guidance to the Underwriting team for Pharmacy rating.&br&&br&&&&b&Responsibilities:&/b&&&&ul&&li&&&Develop prospective and renewal pharmacy rates and terms (AWP discounts, rebates, and administrative fees) for group accounts in accordance with corporate and underwriting guidelines.&&&/li&&li&&br&Collaborate with both internal and external colleagues in developing client-specific pharmacy pricing strategies.&/li&&li&Work with proposal unit to ensure responses, including pertinent definitions and caveats, to all RFPs are complete and accurate.&/li&&li&Support internal underwriting staff regarding pharmacy pricing questions. &/li&&li&Effectively communicate pharmacy pricing decisions to other departments when necessary.&/li&&li&Assist in the training process and mentoring of the Underwriting team related to pharmacy pricing. &/li&&li&Analyze data from the PBM underwriting staff to produce market appropriate proposals.&/li&&li&Contribute to the development of new pharmacy pricing formulas, methodologies, and guidelines.&/li&&li&Prepare pharmacy reporting to provide for book of business insights.&/li&&li&Assist with testing new pricing, underwriting and front-end systems as needed.&/li&&li&Ensure the proper administration of underwriting and legislative guidelines for new and renewing groups.&/li&&li&Achieve overall corporate financial goals by applying appropriate pharmacy pricing methodologies.&/li&&li&Build winning financial offers that balance internal profitability and ensure competitiveness in the market.&/li&&/ul&&&&b&Additional responsibilities for the Lead level:&/b&&&&ul&&li&Serves as primary liaison with external PBM underwriting staff.&/li&&li&Serve as the primary point of contact and subject matter expert for the ASC pharmacy line of business in corporate and divisional underwriting project planning.&/li&&li&Represent Underwriting in Cambia workgroups and strategy sessions and serve as department representative where applicable.&/li&&li&Act as the liaison between various internal departments to ensure open communication and bring transparency to pharmacy underwriting functions.&/li&&li&Provide leadership in the improvement of pharmacy underwriting work processes as needed. &/li&&li&Consult with Legal and Pharmacy to ensure contractual terms, caveats, and other pertinent information is accurate and supports the offer as underwritten.&/li&&li&Partner with Legal to ensure final contract reflects the accepted financial offer.&/li&&li&Coordinate and support training as needed for pharmacy policies, procedures, and systems.&/li&&li&Support the development of and consistent administration of policies and procedures for ASC pharmacy pricing.&/li&&/ul&&&&b&Minimum Requirements:&/b&&&&ul&&li&&&Prior experience with a major Pharmacy Benefit Manager, Health Plan, Pharmacy Brokerage or Consulting Practice. &&&/li&&li&&br&Extensive knowledge of the health insurance and PBM industry and pricing practices.&/li&&li&Demonstrated detailed knowledge of PBM pricing and concepts, including complex terms and conditions and their impact on the overall offer position.&/li&` ```&li&Successfully demonstrated skills and experience in underwriting and pricing of various funding options and products.&/li&&li&Ability to build and maintain positive internal and external customer interactions.&/li&&li&Demonstrated attainment of a high level of independent, consistent performance.&/li&&li&Ability to organize, plan, prioritize and complete complex assignments with little or no supervision.&/li&&li&Demonstrated high level of attention to detail and quality.&/li&&li&Proven understanding of business, including finance, accounting, economics, and risk management.&/li&&li&Demonstrated ability to read the marketplace and competitive environment.&/li&&li&Ability to prioritize tasks and meet deadlines.&/li&&li&Effective verbal and written communications.&/li&&li&Strong team player with a customer service approach.&/li&&li&Demonstrated technology proficiency, including Excel, Word, Teams and applicable software applications.&/li&&/ul&&&&b&Additional Minimum Requirements for Lead:&/b&&&&ul&&li&Exceptional communication skills, ability to distill complex material into easy-to-understand presentations, effectively respond to questions, and engage a variety of audiences.&/li&&li&Experience developing and improving existing best practices for pharmacy underwriting.&/li&&li&Demonstrated project management skills for complex projects.&/li&&li&Acts as a pharmacy underwriting resource to lead

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