Summary
Reporting to the EVP, Chief Client Officer the Director, Pharmacy Underwriting & Analytics provides comprehensive underwriting and pharmacy analytics in support of organic growth and existing clients for Exponent Health’s set of pharmacy solutions. The position provides insights on, thought leadership, and corrective or mitigating actions around emerging pharmacy trends for The Company’s pharmacy businesses. The position will support new business growth by forecasting future revenue, costs, and margins by leveraging underlying utilization data and applying forecasting based on projected future trends. This position will provide analytic leadership on new products and solutions including the development of financial models to support product innovation. This position has direct accountability for organizational sales and client retention efforts through the use and development of pricing & profitability models and forecasting tools to retain existing business and win new customers.
Major responsibilities
- Responsible for reviewing the financial sections of Requests for Proposals (RFPs) and in collaboration with the EVP, Client Client Officer, CFO, Sales, and/or Account Management, determine and position product and pricing solutions for consideration
- Present analysis, opportunities and recommendations to senior management to help build/refine/manage the complete process from receipt of RFP/Pricing requests through communication of financial agreements to internal departments.
- Serve as an internal subject matter expert to support development and design of data warehouse and internal/external dashboard and KPI reporting requirements
- Develop and implement innovative pharmacy strategies that drive enterprise revenue.
- Partner with finance, sales, account management and other key business unit leaders to develop, recommend, communicate, sell and implement competitive pricing strategies.
- Share financial insights and observations with senior leadership and executives related to risk assessment and overall competitiveness; leverage an in-depth understanding of the company portfolio, pharmacy industry trends and market dynamics to influence decisions and encourage senior leaders to embrace new and differentiated competitive strategies.
- Develop and lead Exponent Health’s pharmacy pricing committee, ensure strong strategy and discipline with an unyielding competitive approach and demonstrate deep understanding of pricing fundamentals and competitive drivers to demonstrate the value proposition and retain clients and win new business.
- Collaborate with Finance, Sales, Legal and key internal stakeholders to develop and negotiate competitive contract language.
- Partner with sales, product development and key internal partners to develop innovative pricing strategies with key clients to win and retain business.
- Provide logistical support to Sales and Account Management staff in presenting data and opportunities for improvement to Clients; including participating directly in customer facing interactions.
- Develop and foster a culture of continuous improvement, working with direct reports to provide guidance and direction on appropriate improvements to support future growth.
Desired qualifications
- Bachelor’s degree in Mathematics, Actuarial Science, Economics, Finance or related field.
- Ten years of relevant experience in financial analysis, healthcare, benefits consulting, actuarial and underwriting or financial services field to include 5 years of experience working with pharmacy pricing and profitability models with an emphasis on rebate estimation and/or guarantee management.
- Technical background in underwriting and risk adjusted rate setting.
- Ability to quickly establish trust, respect and credibility and form close working relationships with all levels of an organization, especially senior leadership team.
- Excellent understanding of pharmacy plan design and rebate administration.
- Experience in identifying, designing, recommending, and implementing efficient, innovative business solutions to clients’ complex pharmacy benefit challenges.
- Demonstrated ability to distill complex concepts or situations into concise and compelling communications; work on multiple complex assignments simultaneously.
- Strong communication and decision-making skills; proven experience collaborating with cross-functional teams to meet business objectives with outstanding results.
- Medical, dental, and vision insurance
- Short term disability and long-term disability
- Life insurance and AD&D
- Supplemental life insurance (Employee/Spouse/Child)
- Healthcare and dependent care Flexible Spending Accounts
- Healthcare Savings Account
- Phone and Internet Allowance
- 401(k) Savings and Investment Plan with company match
- Paid time off
- Remote work environment
To apply for this job please visit hrgi.isolvedhire.com.
