Pharmacy Underwriter / Actuarial Analyst
- Hiring from
- United States
- Work type
- Hybrid
- Posted
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- Monitor emerging pharmacy expenses and rebate trends. Based on these and known/projected contract and other key drivers, support the development of trend forecasts to be used for financial projections, rating, and performance monitoring purposes.
- Accurately calculate and analyze a variety of self-funded employer group pharmacy rates using the historical utilization of the account. Extract and analyze historical data of the account to ensure accuracy and good logic. Analyze the overall composition of the group to ensure that the total risk is not excessive. Produce and audit rate renewals, rate filing worksheets, and exhibits for moderately complex to highly complex accounts using pre-established guidelines and templates as a basis for analysis, performing necessary additional research on issues that fall outside these guidelines. Provide consultation to Account Management and Sales and explain rationale and best rating practices for highly complex accounts to assist in rate renewal process. Collaborating with the Underwriting team and account management team to ensure rates and financial options are appropriate.
- Create revenue and expense projections at the group and line of business level. Monitor emerging experience against these projections and produce variance analyses on a regular basis.
- Partner with account management and underwriting staff on new and renewal rating discussions. Interface with external brokers, consultants, and accounts. Provide input regarding underwriting guidelines and procedures. Support the development, maintenance and enhancements of HMSA's commercial pharmacy group rating engine.
- Perform all other miscellaneous duties and responsibilities as directed or assigned.
- Bachelor's degree and three years of related experience in pharmacy underwriting or equivalent combination of education and work experience.
- Demonstrated ability to work quickly and accurately with basic math formulas and concepts including fractions, percentages, ratios, and proportions. Apply mathematical logic in practical situations.
- Demonstrated ability to read and interpret documents such as group agreements, financial reports and procedure manuals.
- Knowledge/experience of medical insurance plans and rating methods.
- Proficient with all group underwriting concepts, practices, and procedures.
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Basic knowledge of Microsoft Office applications. Including but not limited to Word, Excel, and Outlook.
