ZipRecruiter

Log In

2

Remote Medicare Supplement Underwriter Jobs in Rio Rancho, NM

All JobsMedicare Supplement Underwriter JobsRemote Medicare Supplement Underwriter JobsRemote Medicare Supplement Underwriter Jobs in Rio Rancho, NM

Remote Medicare Supplement Underwriter information

What does a remote Medicare Supplement Underwriter do?

A Remote Medicare Supplement Underwriter evaluates applications for Medicare Supplement insurance policies, assessing risk factors such as medical history, age, and other criteria to determine eligibility and appropriate premiums. Working remotely, they review documentation, communicate with applicants or agents as needed, and ensure compliance with regulatory guidelines. Their goal is to make fair decisions that protect both the insurance company and policyholders, all while working efficiently from a remote location.

What are the key skills and qualifications needed to thrive as a remote Medicare Supplement Underwriter?

To thrive as a Remote Medicare Supplement Underwriter, you need strong analytical skills, a solid understanding of Medicare regulations, and experience in health or life insurance underwriting, typically supported by a relevant degree or certification such as LOMA or AHIP. Familiarity with underwriting software, CRM systems, and electronic document management tools is essential. Excellent attention to detail, strong communication, and the ability to work independently are standout soft skills for this remote role. These skills ensure accurate risk assessment, regulatory compliance, and effective collaboration with clients and internal teams in a virtual environment.

What are some common challenges faced by remote Medicare Supplement Underwriters and how can they be managed?

Remote Medicare Supplement Underwriters often encounter challenges such as staying updated on frequent regulatory changes, managing a high volume of applications, and maintaining effective communication with both team members and agents in a virtual environment. To manage these, it's important to establish a reliable workflow, utilize collaboration tools, and participate in regular training sessions. Staying organized and proactive with ongoing education helps ensure accurate and timely underwriting decisions while working remotely.

What is the difference between Remote Medicare Supplement Underwriter vs Remote Medicare Claims Processor?

AspectRemote Medicare Supplement UnderwriterRemote Medicare Claims Processor
Required CredentialsInsurance licenses, underwriting certificationsMedical coding certifications, claims processing training
Work EnvironmentHome office, insurance companies, underwriting teamsHome office, healthcare providers, insurance companies
Industry UsageInsurance industry, Medicare supplement plansHealthcare and insurance industry, claims management

The Remote Medicare Supplement Underwriter primarily evaluates applications for Medicare supplement plans, requiring underwriting knowledge and insurance licenses. In contrast, the Remote Medicare Claims Processor handles claims submissions and processing, focusing on medical coding and claims management. Both roles are remote, but they serve different functions within the Medicare industry, with distinct certifications and daily tasks.

What job categories do people searching Remote Medicare Supplement Underwriter jobs in Rio Rancho, NM look for?

The top searched job categories for Remote Medicare Supplement Underwriter jobs in Rio Rancho, NM are:

What cities near Rio Rancho, NM are hiring for Remote Medicare Supplement Underwriter jobs?

Cities near Rio Rancho, NM with the most Remote Medicare Supplement Underwriter job openings:

Remote Medicare Supplement Underwriter jobs near you
Infographic showing various Remote Medicare Supplement Underwriter job openings in Rio Rancho, NM as of August 2026, with employment types broken down into 21% Full Time, 75% Part Time, and 4% Contract. Highlights an 99% Physical, and 1% Remote job distribution.

Lead Actuary - REMOTE

Albuquerque, NM • On-site, Remote

Prime Therapeutics LLC
Insurance Services • 1 - 5K employees

7.9

Company rating: 7.9 out of 10

Based on 48 frontline employees who took The Breakroom Quiz

16th of 113 rated pharmacies

People enjoy working here

Good employer

Paid breaks

Learn more about Prime Therapeutics LLCexternal

$124K - $211K/yr

Full-time

Re-posted 25 days ago

Job description

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
Job Posting Title
Lead Actuary - REMOTEJob Description
The Lead Actuary is responsible for supporting the development of actuarial concepts and providing thought leadership for Prime's existing and potential owners and clients. This position will collaborate with the Senior Principal Actuary to provide strategic consulting support, manage the development of innovative actuarial modeling concepts, and provide pricing support for all lines of business. This position will also lead complex projects that are highly visible to executives and across the organization.
Responsibilities
  • Collaborate as a subject matter expert (SME) with underwriters, other areas of Prime, and senior management on pricing initiatives, data analyses, and the Request for Proposal (RFP) process
  • Lead, manage, and review data analyses, reporting, and projections
  • Lead, manage, and review ad hoc complex pharmacy data mining and analyses to help investigate and answer challenging questions regarding actuarial data and concepts
  • Provide strategic pricing advice on structures and methodology using market research, financial projections, and complex actuarial modeling
  • Present results and analyses to key stakeholders, senior management, and clients; answer detailed and challenging questions regarding actuarial data
  • Lead and mentor Actuarial team members to enhance actuarial knowledge
  • Monitor the Health Policy environment considering the implication of organization pricing policies, law, and political changes that may impact client programs
  • Ensure all work is consistent with federal regulations and actuarial standards, as applicable
  • Other duties as assigned

Minimum Qualifications
  • Bachelor's degree in Math, Actuarial Science, Economics or Finance
  • 8 years of actuarial work experience to include 6 years in a healthcare organization or PBM
  • Actuarial designation (ASA or FSA)
  • Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications
  • Advanced level of proficiency in Excel; intermediate level of proficiency in SAS, SQL, or VBA
  • Excellent quantitative, problem solving, and analytical skills
  • Strong project management and organizational skills
  • Excellent verbal and written communication skills
  • Strong client consulting presence
  • Excellent presentation and facilitation skills

Preferred Qualifications
  • 8 years of actuarial work experience in a healthcare organization or PBM
  • Previous experience pricing Commercial, Medicare or Medicaid lines of businesses
  • 5 years of experience in SAS, SQL, or VBA
  • Previous experience in model building and underwriting or risk adjusted rate setting, or model development
  • Previous experience in identifying, designing, recommending, and implementing efficient, innovative business solutions to clients' complex pharmacy benefit challenges

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
Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.
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 and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).
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 (including pregnancy), 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 logo

About Prime Therapeutics

Sourced by ZipRecruiter

Prime Therapeutics, located in Eagan, MN, is a pharmacy benefits management company that has been serving the healthcare industry since its foundation. They are an integral participant in the medical sector, specifically in the realm of health insurance. They focus on providing innovative pharmacy benefits and services to more than 30 million members nationwide. Besides their main pharmacy benefit management, they offer mail service pharmacy, specialty pharmacy, benefits management, and consultative engagement services to ensure individuals have continuous access to affordable prescription drugs. Prime Therapeutics, founded around three decades ago, has grown to stand out as a leader in its industry, thanks to its commitment to improving the health of its clients.

Industry

Insurance services

Company size

1,001 - 5,000 Employees

Headquarters location

Eagan, MN, US

Year founded

1987

Social media

FacebookTwitter

View All Prime Therapeutics Jobs

What Prime Therapeutics employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply