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CareFirst BlueCross BlueShield · 1 week ago

Underwriting Manager - Pharmacy (Remote)

United States

Full-time

Remote

Senior Level

$115K/yr - $213K/yr

5+ years exp

CareFirst BlueCross BlueShield is seeking an Underwriting Manager for their Pharmacy division. The role involves providing insurance underwriting services, managing staff, and overseeing pharmacy-related underwriting functions to ensure appropriate pricing, risk mitigation, and compliance.

Health CareNon ProfitService Industry

No H1B

Responsibilities

Manages insurance underwriting employee outcomes by recruiting, selecting, orienting, training, assigning, scheduling, coaching, counseling, and disciplining employees; communicating job expectations; planning, monitoring, appraising, and reviewing job contributions; planning and reviewing compensation actions; enforcing policies and procedures

Achieves insurance underwriting operational objectives by contributing information and analysis to strategic plans and reviews; preparing and completing action plans; implementing production, productivity, quality, customer-service, safety, security, and health standards; identifying and resolving problems; completing audits; identifying, developing, and implementing system improvements

Meets insurance underwriting financial objectives by estimating requirements; preparing an annual budget; scheduling expenditures; analyzing variances; initiating corrective actions

Completes insurance underwriting by evaluating exceptions and appeals; reviewing reinsurance arrangements; enforcing adherence to internal and external underwriting policies, procedures, guidelines, and regulations; auditing risk acceptability, new applications, declined files, and large limits; evaluating loss history, financial statements, and loss control surveys

Ensures legal compliance by auditing and enforcing guidelines, account contracts, and company business plan; verifying implementation of State-mandated regulations and required forms and rates; approving documents for State filings, and marketing materials. Protects organization value by keeping information confidential; cautioning others regarding potential breaches

Resolves insurance problem escalations by evaluating file documentation; evaluating options; enforcing guidelines. Improves insurance product profitability by analyzing product results

Improves insurance underwriting job knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the-art practices; participating in professional societies. Contributes to insurance underwriting and organization success by welcoming related, different, and new requests; helping others accomplish job results

Qualification

Underwriting methodsPharmacy benefit structuresInsurance complianceSupervisory experienceCommunication skillsInterpersonal relationshipsPerformance assessmentCompensation insurance knowledgeReport creation

Required

Bachelor's Degree OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience

5 years progressive underwriting experience group health, medical, ancillary and/or pharmacy

1 year supervisory experience or demonstrated progressive leadership experience

Knowledge of insurance underwriting methods and procedures

Excellent communication skills both written and verbal

Skill in monitoring/assessing the performance of self, other individuals, or organizations to make improvements or take corrective action

Ability to maintain effective interpersonal relationships

Knowledge of compensation insurance; rules, classifications, statues, and rates

Ability to apply underwriting methods to create comprehensive reports