Remote Plan Review Jobs in Seattle, WA (NOW HIRING)

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.

The Senior Underwriter is responsible for achieving profit, growth, service and expense objectives through the financial analysis and pricing of Prime's book of business. Under minimal supervision, the Senior Underwriter serves as an expert consultant on matters pertaining to underwriting, performance guarantees and other financial considerations. Provides underwriting services to determine pricing and monitors accounts to ensure they remain on a profitable basis. Maintains and applies knowledge of pricing strategies in the PBM industry. Maintains a positive working relationship with Sales, Marketing and Client Engagement and other key business owners within Prime.

Responsibilities

• Evaluates the utilization and financial experience of customers and prospects, many of which are very complex
• Performs claims re-pricing analyses for the most complex external claims data
• Provides support to Sales, Marketing and Client Engagement, assisting in the development of client presentations and negotiations pertaining to pricing and guarantees
• Consults with other departments such as Legal, IT, HPS and Marketing, and participates in meetings as required on issues that have financial implications
• Other duties as assigned

Minimum Qualifications

• 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
• 5 years of related work experience in Finance or Accounting
• Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

• Prior work experience in the PBM and/or healthcare industry
• In-depth knowledge of mathematical applications used in underwriting function is required, 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 effectively present information and respond to questions in one-on-one or small group situations
• Proficient in MS Office applications, particularly Excel, Word and PowerPoint

Preferred Qualifications

• 2 years as a Senior Underwriter or Benefits Consultant
• Proficient with Salesforce.com

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.

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 LLCis 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.