Blue Cross Blue Shield - Boston, MA
posted 3 months ago
At Blue Cross Blue Shield of Massachusetts, the Underwriter / Pharmacy Specialist plays a crucial role in ensuring the financial wellbeing of the organization. This position is integral to the underwriting process, which influences various business segments including Marketing, Product Portfolio, Infrastructure Planning, and Network Planning. The Underwriter will not only handle account underwriting responsibilities but will also have the opportunity to engage in project teams aimed at enhancing operational processes and strategic business initiatives. This collaborative environment allows for skill development and career advancement while contributing to a mission-critical business function. The Underwriter / Pharmacy Specialist will act as a liaison between the Underwriting and Pharmacy departments, representing Underwriting in strategic and implementation efforts. This role requires the development of strong working relationships with the Pharmacy Benefit Manager (PBM) to drive partnership and accountability. The Underwriter will serve as a Subject Matter Expert (SME) in Pharmacy, leading the completion of RX quotes and Requests for Proposals (RFPs). Coordination with the Proposal Unit is essential to ensure accurate and timely RFP completion, while consulting with the Actuarial Team to develop and implement Pharmacy Pricing Strategies. In this role, the Underwriter will master complex components of pharmacy pricing, articulating competitive differences between BCBSMA and competitor proposals to both internal and external audiences. The position also involves utilizing Rx tracking and settlement processes, reporting results to leadership, and enforcing adherence to Underwriting Guidelines. The Underwriter will monitor and report on the profitability and persistency of their assigned book of business, maintaining a high level of service to sales representatives and clients regarding renewal and proposal timeliness and accuracy. Additionally, the Underwriter will participate in the development of new products and rating methodologies, meet with colleagues in Sales, and present to senior client management and consultants. The ability to model and forecast complex analyses clearly and concisely is essential, as is the identification of areas for potential process improvement and taking ownership of their development and implementation across the department.