Senior Manager, Underwriting

Description:
• Develop comprehensive proposal strategies for Pharmacy RFPs
• Developing and maintaining a deep understanding of PBM financial levers within Commercial, Medicaid, Medicare Part D, and Public Exchange lines of business.
• Conduct market and competitive analyses to understand industry trends, client needs, and competitor offerings.
• Client relationship management by engaging with the client to understand their specific needs and concerns, building a strong, trust-based relationship and positions the company as a preferred partner.
• Leading end to end financial optimization and pricing activities across Caremark’s PBM Health Plan clients ensuring timeliness, accuracy, and consultative value of analytic output.
• Performance metrics and reporting by establishing and monitoring key performance indicators (KPIs) related to RFP success rates, turnaround times, and client satisfaction.
• Provide regular reports and insights to senior management to inform strategic decision-making and drive continuous improvement in the underwriting process.
• Communicating with key internal partners such as Sales and Account Management, Trade, Networks, IT and Product Development.
• The incumbent will work directly with the external clients to develop a deep understanding of their business and goals to assist with creating and supporting products and solutions that align with their strategy.
• Developing and maintaining effective working relationships with key internal partners across the enterprise, including executive-level decision makers.
• Guiding pricing consultation and strategy in an evolving regulatory environment to ensure compliance.
• Exercising sound business judgment to achieve proper balance between client retention and CVS Caremark profitability.
• Acquiring and maintaining leading-edge knowledge of PBM plan management strategies and solutions.
• Participating in external client and consultant meetings.
• Providing domain expertise across the full spectrum of financially related efforts aimed at retaining and growing the revenue and profitability on behalf of CVS and the client, including leading client renewals, conducting market check pricing, and identifying and communicating opportunities to increase revenue and profit margins across areas such as plan design, channel, clinical, and other solutions.
• Deep understanding of different lines of business (ex. fully insured, ASO, Medicaid, Medicare, Exchanges) to provide relevant recommendations and to influence client adoption of custom and standard solutions.
• Cultivating and maintaining relationships with key internal partners within the Division as well as identifying and communicating opportunities to increase revenue and margin at a client-level as well as use data to identify and position opportunities to drive value.
• Maintaining overall accountability for implementing and overseeing processes
• Collaborating with internal partners to develop products and services that bring to bear CVS Caremark’s enterprise assets, differentiate the firm from its retail/PBM competitors, and attract and retain health plan lives.
• Working independently in a fast-paced environment and handling tight deadlines with appropriate level of delegation to team members.
• Supporting CVS Health in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve.

Requirements:
• 7+ years of prior underwriting or financial analysis experience
• 5+ years of professional experience, preferably within a PBM or health plan.
• Understanding of quality measures such as HEDIS and Star ratings and their importance to customers.
• Broad knowledge of the overall enterprise infrastructure, including operational systems and data warehouses.
• Experience with health plans that are highly custom in their approach to pharmacy benefit services – complex pricing arrangements, custom formularies, clinical programs, channel solutions, and integrated benefit designs.
• Requires knowledge of PBM profit levers, underwriting and financial models.
• Understanding of healthcare and pharmacy claims data and common tools used to manipulate data.
• Exceptional communication skills across the full spectrum of formal and informal channels and to multiple audiences, including external clients, consultants, internal partners, and executive leadership.
• Proven ability to educate and influence external customers and internal partners.
• Ability to manage and deliver on client expectations within assigned book of business.
• Skilled at collaborating and working across a complex matrixed organization.
• Experience working with varying levels of client contacts, including executive leadership, Chief Medical Officers, pharmacy department leadership, provider networks, actuaries, financial analysts, and consultants.

Benefits:
• Affordable medical plan options,
• a 401(k) plan (including matching company contributions),
• and an employee stock purchase plan .
• No-cost programs for all colleagues including wellness screenings,
• tobacco cessation and weight management programs,
• confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off,
• flexible work schedules,
• family leave,
• dependent care resources,
• colleague assistance programs,
• tuition assistance,
• retiree medical access and many other benefits depending on eligibility.

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