Manager, Pricing and Underwriting

🔥 2 minutes ago

🏈 Alabama, Arizona, +32 more states – Remote

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💵 $96.5k - $118.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💰 Pricing Analyst

👻 Ghost score 0%

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Navitus Health Solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2003

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

Navitus Health Solutions is a pharmacy benefit manager (PBM) that provides transparent, people-centered pharmacy benefit solutions to health plans, employers, government programs and other plan sponsors. The company operates a 100% pass-through, cost-plus model that emphasizes lowering medication costs, managing formularies, specialty drug management (including a cost-plus specialty pharmacy), claims adjudication, pharmacy network management, and member enablement and support services. Navitus positions itself as a fiduciary partner focused on affordability, compliance, clinical quality and improving health outcomes through tailored PBM services and digital health integrations.

📋 Description

• Manage pricing and underwriting functions for new business, renewal business, client pricing requests, RFP responses, finalist presentations, and ad hoc financial analyses. • Lead, coach, and train supervisors and analysts to support accurate, timely, and consistent pricing, underwriting, and risk analysis deliverables. • Oversee interpretation and application of claims utilization, network pricing, pharmaceutical rebate pricing, administrative fee pricing, trend, government services impacts, client profitability, and other relevant data. • Direct development, maintenance, and use of pricing models, risk evaluation models, and client profitability models. • Evaluate pricing risk, financial guarantee exposure, and value derived from client relationships. • Maintain and apply underwriting guidelines, pricing standards, approval processes, policies, procedures, work instructions, and quality assurance practices. • Participate in client-facing meetings, finalist presentations, and internal strategy discussions. • Support periodic leadership reporting on pricing, underwriting, client profitability, business value, risk exposure, actual-to-expected performance, and related metrics. • Identify and implement process improvements, model enhancements, reporting improvements, training opportunities, and quality assurance practices. • Establish, mentor, and develop team members through coaching, feedback, and career planning. • Perform other duties as assigned.

🎯 Requirements

• Bachelor’s degree, preferably in Statistics, Mathematics, Finance, Actuarial Science, Economics, Risk Management, or Business, required. • 4+ years of pricing and/or underwriting experience in pharmacy benefit management, managed care, or adjacent setting required. • 2+ years of progressive leadership experience, which may include leading individual contributors or teams, or equivalent leadership experience such as coaching, mentoring, or leading complex initiatives or projects, required. • Experience working in the pharmacy benefit management industry preferred. • Experience using financial valuation models and analyzing results preferred. • Participate in, adhere to, and support compliance program objectives. • The ability to consistently interact cooperatively and respectfully with other employees. • Residents must be located in one of the eligible U.S. states or Washington, DC.

🏖️ Benefits

• Top of the industry benefits for Health, Dental, and Vision insurance • 20 days paid time off • 4 weeks paid parental leave • 9 paid holidays • 401K company match of up to 5% - No vesting requirement • Adoption Assistance Program • Flexible Spending Account • Educational Assistance Plan and Professional Membership assistance • Referral Bonus Program – up to $750! • STAR Bonus % (At Risk Maximum): 10.00