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Blue Cross Blue Shield of Massachusetts · 1 day ago

Pharmacy Underwriter IV

Boston, MA

Full-time

Onsite

Mid, Senior Level

$107K/yr - $131K/yr

7+ years exp

Blue Cross Blue Shield of Massachusetts is seeking a Pharmacy Underwriter IV to support the financial wellbeing of insurance companies. This role involves acting as a liaison between Underwriting and Pharmacy departments, coordinating RFPs, and developing pricing strategies while ensuring adherence to Underwriting guidelines.

AssociationCommunitiesHealth InsuranceInsuranceMedicalNon Profit

H1B Sponsor Likely

Responsibilities

Act as Liaison between Underwriting and Pharmacy departments representing Underwriting in strategy and implementation efforts

Act as Liaison between Underwriting Department and our PBM developing working relationships that drive partnership and accountability

Act as Underwriting Pharmacy SME supporting department in leading completion of RX quotes and RFPs

Coordinate with Proposal Unit to ensure accurate and timely RFP completion

Consult with Actuarial Team to develop and implement ASC Pharmacy Pricing Strategies

Master complex components of pharmacy pricing being able to articulate competitive differences of BCBSMA and competitor proposals to internal and external audiences

Master utilization of Rx tracking and settlement processes and report results to leadership

Enforce adherence to Underwriting Guidelines and be responsible for approval of exceptions

Monitor and report on the profitability and persistency of the assigned book of business

Maintain consistent high level of service to our sales representatives and clients with respect to renewal and proposal timeliness and accuracy

Participate in the development of new products and rating methodologies

Meet and present and consult with colleagues in Sales and externally with senior client management and/or their consultant

Confidently model and forecast complex analyses in a clear and concise manner and present to senior/executive levels of leadership (internally and externally) on a frequent basis

Identify areas for potential process improvement and take ownership/participate in their development and implementation across the department

Qualification

Pharmacy UnderwritingPharmacy programs knowledgeRebate optimizationPBM experienceMicrosoft OfficeProcess improvementOral communicationWritten communicationCreative problem solving

Required

Undergraduate or Masters Degree is required

Minimum of seven years Pharmacy Underwriting or related Underwriting experience is required

Must have an extensive knowledge of Pharmacy programs, rebate optimization and modeling

Must possess superior oral and written communication skills with the ability to present information to a variety of audiences

A creative problem solving ability is required

Ability to work in a fast paced, high-volume environment

Must be familiar with Microsoft Office

Benefits

Paid time off

Medical/dental/vision insurance

401(k)

A suite of well-being benefits to eligible employees

Company

Blue Cross Blue Shield of Massachusetts

Glassdoor3.4

Blue Cross Blue Shield of Massachusetts is a state licensed private health insurance company

Founded in 1937

Boston, Massachusetts, USA

1001-5000 employees

https://www.bluecrossma.org

H1B Sponsorship

Blue Cross Blue Shield of Massachusetts has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (11)

2024 (21)

2023 (8)

2021 (2)

2020 (6)