Job Overview
Location
Home
Job Type
Full-time
Category
HR & Recruiting
Date Posted
April 2, 2026
Full Job Description
đź“‹ Description
- • As Director of Health Plan Underwriting at Prime Therapeutics, you will lead a critical team that drives pricing strategy and financial performance for the organization’s pharmacy benefit management offerings, directly impacting how Prime delivers value to health plan clients and members through data-informed underwriting decisions.
- • You will provide strategic leadership and operational oversight to ensure underwriting analyses are accurate, timely, and aligned with corporate margin and growth objectives, serving as a trusted advisor to client engagement, legal, and executive leadership teams.
- • Day to day, you will guide a team of underwriters and managers in delivering expert support for RFP responses, pricing models, and contract negotiations, ensuring all financial proposals are complete, compliant, and strategically sound.
- • You will collaborate with client engagement teams to develop and execute pricing and margin strategies tailored to specific health plan needs, leveraging underwriting insights to win and retain business in competitive markets.
- • You will oversee workflow coordination across the underwriting unit, ensuring standard operating procedures are followed, bids are properly tracked and documented, and performance metrics are monitored for continuous improvement.
- • You will consult with Legal and Client Engagement to validate contractual terms, definitions, and caveats in RFP responses, ensuring accuracy and alignment with underwritten assumptions and risk tolerances.
- • You will assist in client contract negotiations as needed, applying your expertise to structure deals that support Prime’s financial objectives while meeting client expectations.
- • You will engage with external consultants and client stakeholders to articulate Prime’s value proposition, demonstrating how underwriting rigor translates into sustainable pricing and performance guarantees.
- • You will partner with management on staffing planning, productivity initiatives, and process improvements to enhance team efficiency and scalability without sacrificing analytical quality.
- • You will ensure compliance with all internal policies, regulatory requirements, and security controls, fostering a culture of accountability and precision in financial decision-making.
- • The Underwriting team operates at the intersection of finance, analytics, and client strategy within Prime Therapeutics—a purpose-driven PBM focused on connecting care beyond profits—where your leadership will directly influence how the company innovates in pharmacy pricing and plan design.
- • In this role, you will deepen your expertise in PBM economics, health plan underwriting, and executive-level influence, positioning yourself as a strategic leader capable of shaping pricing methodologies that drive both margin growth and client satisfaction in the evolving pharmacy benefits landscape.
🎯 Requirements
- • Bachelor’s degree in Mathematics, Accounting, Finance, or a related field, or equivalent combination of education and relevant work experience; high school diploma or GED required.
- • Minimum of 8 years of related experience in underwriting, pricing, financial analysis, or a comparable analytical role within healthcare, insurance, or pharmacy benefit management.
- • At least 5 years of proven leadership or people management experience, including direct supervision of analysts, underwriters, or teams delivering financial or strategic support.
- • In-depth knowledge of mathematical applications in underwriting, including proficiency in calculating discounts, proportions, percentages, and applying business mathematics and algebra to pricing and margin analysis.
- • Exceptional communication skills, with the ability to translate complex financial and underwriting concepts into clear, persuasive presentations for diverse audiences, including senior and executive leadership.
- • Demonstrated ability to influence and persuade executive stakeholders at Prime, Blue plans, and prospective clients to support pricing strategies that align with margin and growth objectives in the self-insured pharmacy market.
🏖️ Benefits
- • Comprehensive health, dental, and vision insurance plans designed to support employee and family well-being.
- • Retirement savings options including 401(k) with company match to help build long-term financial security.
- • Paid time off and holidays to promote work-life balance and mental health recovery.
- • Professional development opportunities and tuition reimbursement to support career growth and skill enhancement.
- • Employee assistance program (EAP) offering confidential counseling, legal, and financial support services.
- • Tobacco-free workplace environment promoting health and wellness as part of Prime’s culture of care.
Skills & Technologies
Remote
Degree Required
About Prime Therapeutics LLC
Prime Therapeutics LLC is a pharmacy benefit management company founded in 1989 and headquartered in Eagan, Minnesota. It administers prescription drug plans on behalf of health plans, employers, and government programs, processing claims, negotiating rebates, managing formularies, and operating specialty pharmacies. Owned by a consortium of Blue Cross and Blue Shield plans, the company serves over 40 million members nationwide while focusing on cost control, clinical outcomes, and member safety.
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