Case Underwriter - Medical

Position Summary:

Case Underwriter is responsible for leading the underwriting for Judi Health and Capital Rx new-business medical TPA and pharmacy RFPs. This new role offers the opportunity to be a part of shaping our underwriting strategy from the ground up for Judi Health medical TPA opportunities. The successful candidate will collaborate with various teams to refine financial models and reporting, present final underwriting to leadership and drive continuous improvement in pricing and underwriting practices. 

Position Responsibilities:

• Direct and execute day-to-day pricing and underwriting for new and renewing business opportunities
• Direct and execute day-to-day pricing and underwriting for new and renewing Judi Health and Capital Rx prospects, covering medical TPA and pharmacy components 
• Coordinate with Sales, Proposal Development and other business functions to submit timely and complete RFP responses 
• Collaborate with Executive Team and other business functions to design, refine, and maintain internal underwriting, financial modeling, and financial reporting SOPs 
• Support client contracting, including validation that contract terms align with proposal underwriting parameters 
• Present final underwriting to Sales and Executive Team and be able to articulate any potential risk 
• Support continued development and maintenance of underwriting and financial reporting system infrastructure 
• Mine external data to determine best underwriting practices for each business opportunity 
• Manage multiple projects and deadlines as needed 
• Work collaboratively across the organization to communicate and support ongoing financial analytics and reporting needs 
• Support analysis and development of pricing models for new products 
• Support general business needs, as required 
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance 

Minimum Qualifications

• Bachelor’s degree, with record of strong academic performance in Accounting, Finance, Actuarial Science, Statistics, or Economics (In lieu of a degree, equivalent relevant work experience may be considered)
• 2+ years of proven experience in financial analysis, actuarial services, accounting, pricing & underwriting
• Pharmacy, PBM, or Health Plan experience required
• 2+ years of Medical Underwriting experience required. Additional experience in Pharmacy, PBM, and/or Health plan Underwriting is preferred
• Knowledge of risk management, statistics, financial modeling
• Data mining experience working with large structured and unstructured data sets 
• Advanced proficiency in Microsoft Excel 
• Experience in either SQL, SAS, or R and data visualization tools is preferred 
• Track record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverables
• Ability to balance multiple complex projects simultaneously
• Exceptional technical, analytical, and problem-solving skills
• Exceptional written and verbal communication skills
• Extremely flexible, highly organized, and able to shift priorities easily
• Attention to detail & commitment to delivering high quality work product