Underwriting Manager - Pharmacy (Remote)

Resp & Qualifications

PURPOSE:
Provides Insurance Underwriting Services by evaluating exceptions and appeals; reviewing reinsurance arrangements; auditing risk acceptability, new applications, declined files, and large limits; evaluating loss history, financial statements, and loss control surveys; evaluating file documentation; analyzing product results; approving documents for State filings, and marketing materials; managing staff.

ESSENTIAL FUNCTIONS:

• Manages insurance underwriting employee outcomes by recruiting, selecting, orienting, training, assigning, scheduling, coaching, counseling, and disciplining employees; communicating job expectations; planning, monitoring, appraising, and reviewing job contributions; planning and reviewing compensation actions; enforcing policies and procedures.

• Achieves insurance underwriting operational objectives by contributing information and analysis to strategic plans and reviews; preparing and completing action plans; implementing production, productivity, quality, customer-service, safety, security, and health standards; identifying and resolving problems; completing audits; identifying, developing, and implementing system improvements.

• Meets insurance underwriting financial objectives by estimating requirements; preparing an annual budget; scheduling expenditures; analyzing variances; initiating corrective actions.

• Completes insurance underwriting by evaluating exceptions and appeals; reviewing reinsurance arrangements; enforcing adherence to internal and external underwriting policies, procedures, guidelines, and regulations; auditing risk acceptability, new applications, declined files, and large limits; evaluating loss history, financial statements, and loss control surveys.

• Ensures legal compliance by auditing and enforcing guidelines, account contracts, and company business plan; verifying implementation of State-mandated regulations and required forms and rates; approving documents for State filings, and marketing materials. Protects organization value by keeping information confidential; cautioning others regarding potential breaches.

• Resolves insurance problem escalations by evaluating file documentation; evaluating options; enforcing guidelines. Improves insurance product profitability by analyzing product results.

• Improves insurance underwriting job knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the-art practices; participating in professional societies. Contributes to insurance underwriting and organization success by welcoming related, different, and new requests; helping others accomplish job results.

Supervisory Responsibility:
This position manages people.

QUALIFICATIONS:

Education Level: Bachelor's Degree OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Experience:

• 5 years progressive underwriting experience group health, medical, ancillary and/or pharmacy.
• 1 year supervisory experience pr demonstrated progressive leadership experience.

Salary Range: $108,320 - $201,069

Salary Range Disclaimer

Salary will be based on education, location, experience, certifications, etc. In addition to your salary, CareFirst offers benefits such as a comprehensive benefits package, incentive and recognition programs, and 401k contribution (all benefits are subject to eligibility requirements).

Department

Pharmacy Underwriting

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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