Case Underwriter (Medical)

TL;DR

Case Underwriter (Medical): Leading the underwriting for new-business medical TPA and pharmacy RFPs with an accent on pricing strategy and financial modeling. Focus on designing internal underwriting SOPs, mining external data for risk assessment, and aligning contract terms with proposal parameters.

Location: Remote (Must be based in the US)

Salary: $100,000 - $110,000 USD

Company

Enterprise health technology company providing pharmacy benefit management (PBM) and health benefit management solutions for employers and health plans.

What you will do

• Direct day-to-day pricing and underwriting for new and renewing medical TPA and pharmacy business opportunities.
• Coordinate with Sales and Proposal Development teams to submit timely and complete RFP responses.
• Design, refine, and maintain internal underwriting, financial modeling, and financial reporting SOPs.
• Validate that client contract terms align with proposal underwriting parameters.
• Mine external data to determine best underwriting practices for each business opportunity.
• Support the analysis and development of pricing models for new products.

Requirements

• Bachelor’s degree in Accounting, Finance, Actuarial Science, Statistics, or Economics.
• 2+ years of Medical Underwriting experience required.
• Pharmacy, PBM, or Health Plan experience required.
• 2+ years of proven experience in financial analysis, pricing, or actuarial services.
• Advanced proficiency in Microsoft Excel; experience with SQL, SAS, or R is preferred.
• Exceptional analytical, technical, and problem-solving skills with experience in data mining.

Culture & Benefits

• Opportunity to shape the underwriting strategy from the ground up in a new role.
• Collaborative work environment involving close interaction with the Executive Team and Sales.
• Company committed to diversity, equity, and equal employment opportunities.
• Focus on rebuilding trust in the U.S. healthcare infrastructure.