Remote: Open to applicants in the United States, excluding CA, IL, ND, NY, OH, WA, and WY. Hybrid ... ACA Individual & Small Group Pricing * Lead annual ACA Individual and Small Group rate development ...
Remote: Open to applicants in the United States, excluding CA, IL, ND, NY, OH, WA, and WY. Hybrid ... ACA Individual & Small Group Pricing * Lead annual ACA Individual and Small Group rate development ...
Sales Director, Miami, Florida
Miami, FL · Remote
$85K/yr
With a diverse portfolio that includes Medicare, ACA, Life, Supplemental, and Group products ... Remote * Weekend availability as business needs require If you're a motivated, bilingual ...
Sales Director, Miami, Florida
Miami, FL · Remote
$85K/yr
With a diverse portfolio that includes Medicare, ACA, Life, Supplemental, and Group products ... Remote * Weekend availability as business needs require If you're a motivated, bilingual ...
Analyst, Business - SQL (Remote in Florida)
Tampa, FL · Remote
$49K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Care Act (ACA). * Medical Coding certification. To all current Molina employees: If you are ...
Analyst, Business - SQL (Remote in Florida)
Tampa, FL · Remote
$49K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Care Act (ACA). * Medical Coding certification. To all current Molina employees: If you are ...
Analyst, Business - SQL (Remote in Florida)
Jacksonville, FL · Remote
$49K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Care Act (ACA). * Medical Coding certification. To all current Molina employees: If you are ...
Analyst, Business - SQL (Remote in Florida)
Jacksonville, FL · Remote
$49K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Care Act (ACA). * Medical Coding certification. To all current Molina employees: If you are ...
Analyst, Business - SQL (Remote in Florida)
Miami, FL · Remote
$49K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Care Act (ACA). * Medical Coding certification. To all current Molina employees: If you are ...
Analyst, Business - SQL (Remote in Florida)
Miami, FL · Remote
$49K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Care Act (ACA). * Medical Coding certification. To all current Molina employees: If you are ...
Analyst, Business - SQL (Remote in Florida)
Saint Petersburg, FL · Remote
$49K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Care Act (ACA). * Medical Coding certification. To all current Molina employees: If you are ...
Analyst, Business - SQL (Remote in Florida)
Saint Petersburg, FL · Remote
$49K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Care Act (ACA). * Medical Coding certification. To all current Molina employees: If you are ...
Analyst, Business - SQL (Remote in Florida)
Orlando, FL · Remote
$49K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Care Act (ACA). * Medical Coding certification. To all current Molina employees: If you are ...
Analyst, Business - SQL (Remote in Florida)
Orlando, FL · Remote
$49K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Care Act (ACA). * Medical Coding certification. To all current Molina employees: If you are ...
Sales Director, Miami, Florida
Miami, FL · On-site +1
$85K/yr
With a diverse portfolio that includes Medicare, ACA, Life, Supplemental, and Group products ... Remote * Weekend availability as business needs require If you're a motivated, bilingual ...
Sales Director, Miami, Florida
Miami, FL · On-site +1
$85K/yr
With a diverse portfolio that includes Medicare, ACA, Life, Supplemental, and Group products ... Remote * Weekend availability as business needs require If you're a motivated, bilingual ...
General Manager, Benefits & Insurance
Miami, FL · Remote
$120K - $250K/yr
Remote ???? Reports to CEO ???? Full-Time ???? Equity Available $120-150K Base Salary $200-250K OTE ... Licensing & Compliance Entity setup, state licensing, carrier appointments, ERISA and ACA ...
Quick apply
General Manager, Benefits & Insurance
Miami, FL · Remote
$120K - $250K/yr
Remote ???? Reports to CEO ???? Full-Time ???? Equity Available $120-150K Base Salary $200-250K OTE ... Licensing & Compliance Entity setup, state licensing, carrier appointments, ERISA and ACA ...
Auditor, Risk Adjustment
Miami, FL · Remote
$82K - $108K/yr
This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and ...
Quick apply
Auditor, Risk Adjustment
Miami, FL · Remote
$82K - $108K/yr
This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and ...
The position will be fully remote! The Partner Development Account Manager helps drive the growth ... Familiarity with ACA Marketplace, employee benefits, Medicare, or healthcare enrollment programs.
The position will be fully remote! The Partner Development Account Manager helps drive the growth ... Familiarity with ACA Marketplace, employee benefits, Medicare, or healthcare enrollment programs.
... remote international team members · Maintain compliance with FLSA, EEOC, OSHA, ACA, HIPAA, and applicable state labor laws · Support internal audits and identify opportunities to improve HR ...
New
Quick apply
... remote international team members · Maintain compliance with FLSA, EEOC, OSHA, ACA, HIPAA, and applicable state labor laws · Support internal audits and identify opportunities to improve HR ...
New
Health Insurance Sales Agent - Contract $20/hr
Monticello, FL · Remote
$20/hr
We are looking to bring on dedicated, driven individuals to join our team that sells Individual/Family Health plans through ACA (Affordable Care Act). * $20/hr plus bonuses * 100% fully remote.
Health Insurance Sales Agent - Contract $20/hr
Monticello, FL · Remote
$20/hr
We are looking to bring on dedicated, driven individuals to join our team that sells Individual/Family Health plans through ACA (Affordable Care Act). * $20/hr plus bonuses * 100% fully remote.
Health Insurance Sales Agent - Contract $20/hr
Tampa, FL · Remote
$20/hr
We are looking to bring on dedicated, driven individuals to join our team that sells Individual/Family Health plans through ACA (Affordable Care Act). * $20/hr plus bonuses * 100% fully remote.
Health Insurance Sales Agent - Contract $20/hr
Tampa, FL · Remote
$20/hr
We are looking to bring on dedicated, driven individuals to join our team that sells Individual/Family Health plans through ACA (Affordable Care Act). * $20/hr plus bonuses * 100% fully remote.
From world-class events that last a few weeks to mining operations and remote communities who rely ... Strong Accountant Background (ACA, ACCA, CPA, or equivalent preferred). * Strong experience in ...
From world-class events that last a few weeks to mining operations and remote communities who rely ... Strong Accountant Background (ACA, ACCA, CPA, or equivalent preferred). * Strong experience in ...
From world-class events that last a few weeks to mining operations and remote communities who rely ... Strong Accountant Background (ACA, ACCA, CPA, or equivalent preferred). * Strong experience in ...
From world-class events that last a few weeks to mining operations and remote communities who rely ... Strong Accountant Background (ACA, ACCA, CPA, or equivalent preferred). * Strong experience in ...
Senior Integration Analyst-Developer - Infor HRT (Landmark Payroll)
Fort Myers, FL · On-site +1
$50.37 - $65.48/hr
Remote - FL Department: Corporate Systems and IT Administration Work Type: Full Time Shift: Shift ... for W2, ACA, etc.). * Collaborate with Payroll leadership & SMEs to analyze issues, validate ...
Senior Integration Analyst-Developer - Infor HRT (Landmark Payroll)
Fort Myers, FL · On-site +1
$50.37 - $65.48/hr
Remote - FL Department: Corporate Systems and IT Administration Work Type: Full Time Shift: Shift ... for W2, ACA, etc.). * Collaborate with Payroll leadership & SMEs to analyze issues, validate ...
Senior Integration Analyst-Developer - Infor HRT (Landmark Payroll)
Fort Myers, FL · Remote
$50.37 - $65.48/hr
Remote - FL Department: Corporate Systems and IT Administration Work Type: Full Time Shift: Shift ... for W2, ACA, etc.). * Collaborate with Payroll leadership & SMEs to analyze issues, validate ...
Senior Integration Analyst-Developer - Infor HRT (Landmark Payroll)
Fort Myers, FL · Remote
$50.37 - $65.48/hr
Remote - FL Department: Corporate Systems and IT Administration Work Type: Full Time Shift: Shift ... for W2, ACA, etc.). * Collaborate with Payroll leadership & SMEs to analyze issues, validate ...
Sr. Benefits Analyst
Fort Lauderdale, FL · Remote
$95K - $120K/yr
This is a fully remote position that offers a competitive salary range of $95,000 to $120,000, plus ... Ensure compliance with US federal, state, and local regulations (e.g., ERISA, ACA, HIPAA, COBRA ...
Sr. Benefits Analyst
Fort Lauderdale, FL · Remote
$95K - $120K/yr
This is a fully remote position that offers a competitive salary range of $95,000 to $120,000, plus ... Ensure compliance with US federal, state, and local regulations (e.g., ERISA, ACA, HIPAA, COBRA ...
In-depth understanding of FLSA, FUTA, SUTA, ACA , and other payroll-related federal and state ... Flexible, remote-friendly work environment.
Quick apply
In-depth understanding of FLSA, FUTA, SUTA, ACA , and other payroll-related federal and state ... Flexible, remote-friendly work environment.
Remote Aca information
What are the key skills and qualifications needed to thrive as a Remote Accountant, and why are they important?
How to make $1000 a week remotely?
How can I make $100,000 a year working from home?
What is the difference between Remote Aca vs Remote Biller?
| Aspect | Remote Aca | Remote Biller |
|---|---|---|
| Required Credentials | Medical coding certification (e.g., CPC) | Medical billing certification or training |
| Work Environment | Home-based, healthcare offices, hospitals | Home-based, healthcare providers, clinics |
| Employer & Industry Usage | Hospitals, clinics, insurance companies | Medical practices, billing companies |
| Common Search & Comparison | Yes | Yes |
Remote Aca and Remote Biller roles often overlap in healthcare billing and coding. While Remote Aca focuses on medical coding and insurance claim processing, Remote Biller emphasizes managing billing processes directly with healthcare providers. Both require relevant certifications and are typically home-based, serving healthcare organizations. Understanding these differences helps job seekers find the role that best matches their skills and career goals.
What are some common challenges faced by Remote Academic Advisors, and how can these be managed effectively?
How can I make 2000 a week working from home?
What are remote Accountants?
What is the highest paying remote job right now?
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- Remote 130K A Year

Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 17 days ago
Job description
Location Address:
9521 San Mateo NE Albuquerque, NM 87113-2237Summary:
Presbyterian Health Plan (PHP) seeks a strategic and analytically driven leader to serve as Director, Underwriting & Pricing. This highly visible leadership role is responsible for developing and executing underwriting, pricing, and rating strategies that support growth, profitability, regulatory compliance, and long-term financial sustainability across the Health Plan.Reporting to senior health plan leadership, this executive oversees underwriting and pricing for commercial large group, level-funded, and Administrative Services Only (ASO) products while providing enterprise leadership for ACA Individual and Small Group rate development and implementation. The Director also leads reinsurance strategy and negotiations across all lines of business and serves as a key partner to Sales, Actuarial, Finance, Product, and Market leadership.
This role is ideal for a leader who combines strong technical underwriting expertise with strategic business acumen, exceptional communication skills, and a proven ability to influence business outcomes in a complex healthcare environment.
Work Arrangement:
Remote: Open to applicants in the United States, excluding CA, IL, ND, NY, OH, WA, and WY.
Hybrid: For individuals within 60 miles of Albuquerque, in-office presence is required Tuesday through Thursday.
Job Description:
Strategic Underwriting & Pricing Leadership
Develop and execute underwriting and pricing strategies for Commercial Large Group, Level-Funded, and ASO business segments.
Partner with executive leadership to support organizational growth, profitability, and market competitiveness.
Contribute to the development and execution of commercial market and sales strategies.
Evaluate emerging market trends and recommend pricing actions to support business objectives.
Financial Performance & Risk Management
Monitor Medical Loss Ratio (MLR) performance across commercial and level-funded products.
Identify emerging financial trends and implement corrective pricing or underwriting actions as needed.
Develop periodic revenue forecasts to support organizational budgeting and provider contracting activities.
Ensure pricing assumptions appropriately reflect benefit design, administrative expenses, commissions, and risk profiles.
ACA Individual & Small Group Pricing
Lead annual ACA Individual and Small Group rate development and implementation processes.
Ensure rate development methodologies comply with all applicable regulatory requirements.
Oversee successful implementation and loading of approved rates into operational systems.
Ensure timely development and distribution of annual renewal communications.
Reinsurance Strategy
Lead negotiation and procurement of reinsurance agreements across all lines of business.
Evaluate market conditions and reinsurance opportunities to optimize financial performance and risk protection.
Partner with Finance and Actuarial leadership to assess and manage enterprise risk exposure.
Regulatory & Compliance Oversight
Ensure timely filing of underwriting guidelines, rating methodologies, and pricing parameters.
Lead annual Federal Employees Health Benefits Program (FEHBP) rate proposal and reconciliation processes.
Support regulatory audits and inquiries, including Office of Inspector General (OIG) reviews.
Maintain compliance with federal, state, and industry underwriting requirements.
Leadership & Talent Development
Lead, mentor, and develop a high-performing underwriting team.
Establish clear performance expectations, accountability measures, and professional development opportunities.
Foster a culture of collaboration, customer service, analytical rigor, and continuous improvement.
Stakeholder Engagement
Serve as a trusted advisor to Sales, Marketing, brokers, and consultants on underwriting and pricing matters.
Evaluate non-standard proposals and exception requests to ensure financially viable decisions.
Effectively communicate complex financial and underwriting concepts to executive, internal, and external stakeholders.
Success Measures
Within the first 12-24 months, the Director will:
Strengthen underwriting and pricing strategies to support profitable membership growth.
Ensure ACA, Large Group, and Level-Funded products achieve targeted financial performance.
Enhance forecasting accuracy and underwriting performance analytics.
Maintain full compliance with regulatory rate filing requirements and audit standards.
Successfully negotiate reinsurance arrangements that balance risk protection and economic value.
Develop and retain a high-performing underwriting team capable of supporting strategic growth objectives.
Additional Job Description:
Required: Bachelor's degree in Business, Finance, Economics, Mathematics, Healthcare Administration, or a related field.
Preferred: Master's degree (MBA, MHA, or related discipline).
Benefits
Benefits are effective day-one (for .45 FTE and above) and include:
- Competitive salaries
- Full medical, dental and vision insurance
- Flexible spending accounts (FSAs)
- Free wellness programs
- Paid time off (PTO)
- Retirement plans, including matching employer contributions
- Continuing education and career development opportunities
- Life insurance and short/long term disability programs
About Us
Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system ofnine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees.
Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans.
We are part of New Mexico's history-and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.
About New Mexico
New Mexico's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque's International Balloon Fiesta, Los Alamos' nuclear scientists, Roswell's visitors from outer space, and Santa Fe's artists, and you get an eclectic mix of people, places and experiences that make this state great.
Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC.
New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.