Senior Underwriter, Pharmacy

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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.

Required Job Qualifications:

• Bachelor's Degree OR 4 years of direct experience in managed care or network management involving independent work and judgment.

• Plus 3 years project management experience including leading and planning projects.

• Managed care/network management database experience including knowledge of information flow.

• PC proficiency to include Word, Excel and PowerPoint.

• Clear and concise verbal and written communication skills including interpersonal and presentation skills.

• Self- starter, meet deadlines, manage multiple tasks/projects, work in a team environment

Preferred Job Qualifications:

• Knowledge of state and federal network management legislation and regulations.

~ KEY FUNCTIONS ~

• Responsible for the management and maintenance of the following operational aspects of network programs

• Project / Enhancements / Initiative planning and implementation

• Cross functional departmental coordination

• Program management and administration including data maintenance / processing, identifying providers for recruitment or education, research and resolution of issues, answering inquiries

• Communications / Training including network management representative training, provider correspondence, webinars and related presentation material development

• Results reporting and analysis coordination

• System Testing

• Coordinate with HCSC plans in support of network programs.

• Perform operational functions for specified network programs and serve as plan lead. Coordinate with internal resources for implementation and operation tasks.

• Establish relationships with appropriate HCSC representatives including technical areas, and coordinate operational activities with HCSC plans to promote synergies and consistency within HCSC.

• Participate in BCA and/or external entities meetings when appropriate.

• Identify and implement continuous improvement opportunities

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

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 .

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

$45,900.00 - $102,100.00

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 View phone number on click.appcast.io 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

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