Demo

Senior Principal, Health Plans Underwriter - REMOTE

Lensa
Providence, RI Remote Full Time
POSTED ON 4/21/2025
AVAILABLE BEFORE 5/20/2025
Lensa is the leading career site for job seekers at every stage of their career. Our client, Prime Therapeutics, is seeking professionals. Apply via Lensa today!

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Senior Principal, Health Plans Underwriter - REMOTE

Job Description

The Senior Principal Underwriter is responsible for driving profit, growth, service and expense objectives through managing the financial analysis and pricing of Prime's book of business. This position is accountable for overseeing the development of recommended pricing terms; offer structure and risk analysis for highly complex and visible cases, primarily in the Health Plan markets that directly impact Prime's goals; profit drivers and the organization's financial value statement. This role serves as a subject matter expert and accountable leader on concerns pertaining to underwriting, performance guarantees and other financial considerations.

Responsibilities

  • Evaluates the utilization and financial experience of customers and prospects; primarily focused on complex cases within the Health Plan marketplace
  • Researches, analyzes, develops and applies advanced knowledge of pricing strategies in the PBM industry; provides underwriting services to determine pricing and monitors accounts to ensure they remain on a profitable basis and if needed, leverages contractual or internal adjustment remedies
  • In partnership with Sales and Client Engagement, provide expertise assisting in the development of client presentations and leads negotiations pertaining to pricing, and performance guarantees
  • Consults with other departments such as Legal and IT, and develops and drives financial presentations to Senior and Executive Leadership teams on financial business decisions to effectively mitigate risk in securing new clients
  • Builds external consultant relationships to evaluate Prime's competitiveness and to improve financial offerings in support of winning new business
  • Leads contracting negotiations as a primary source of financial truth in legal contracting of new and existing clients, ensuring detailed contract clauses match the underlying financials and do not put company at additional risk 20%
  • Develops and maintains a strong positive working relationship with Senior leadership in many areas, including Sales, Network Management, Trade Relations, and Client Engagement, as well as other key business owners within Prime 5%
  • May manage staffing, performance and development of a small team of underwriters and mentor other junior members of the team
  • Advocates for and leads business requirements for underwriting tools and processes
  • Other duties as assigned

Education & Experience

  • Bachelor's degree in mathematics, accounting, or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
  • 10 years of related work experience in Finance or Accounting, including 3 years in the PBM industry
  • Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

  • In-depth knowledge of mathematical applications used in underwriting function, including the ability to calculate figures such as discounts, proportions and percentages, as well as the ability to apply basic concepts of business mathematics and algebra in underwriting problems
  • Ability to conduct complex in-depth analysis to drive business and contractual outcomes
  • Exceptional communication skills; ability to distill complex material into easy to understand presentations, effectively respond to questions and engage a variety of audiences
  • Ability to effectively present information and influence Senior and Executive Leadership decisions
  • Works well under stressful situations with competing deadlines and goals
  • Ability to negotiate with difficult external audiences
  • Excellent written and verbal communication skills
  • Strong eye for detail and excellent retention of salient details
  • Advanced level of proficiency in MS Office applications, particularly Excel, Word and PowerPoint

Preferred Qualifications

  • PBM Analytics (Google Cloud (GCP), Excel, SQL
  • Progressive leadership experience

Physical Demands

  • Constantly required to sit, use hands to handle or feel, talk and hear
  • Frequently required to reach with hands and arms
  • Occasionally required to stand, walk and stoop, kneel, and crouch
  • Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
  • Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

Potential pay for this position ranges from $124,000.00 - $211,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/benefits) and click on the "Benefits at a glance" button for more detail.

_Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.   _

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.

Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.

If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.   

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.

Salary : $124,000 - $211,000

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