[Hiring] Manager, Pricing and Underwriting @Navitus Health Solutions, LLC

Role Description

Due to growth, we are adding a Manager, Pricing and Underwriting to our team. The Manager, Pricing and Underwriting supports and manages core functions across the full scope of pricing, underwriting, and risk analysis. This position reports to the Director, Pricing and Underwriting and will provide leadership to Supervisors and Analysts. The Manager is responsible for developing pricing recommendations, evaluating financial risk, maintaining underwriting models, and supporting pricing decisions for new business, renewal business, client retention, and RFP opportunities.

Responsibilities

• Manage pricing and underwriting functions for new business, renewal business, client pricing requests, RFP responses, finalist presentations, and ad hoc financial analyses.
• Lead, coach, and train supervisors and analysts to support accurate, timely, and consistent pricing, underwriting, and risk analysis deliverables.
• Oversee the interpretation and application of claims utilization, network pricing, pharmaceutical rebate pricing, administrative fee pricing, trend, government services impacts, client profitability, and other relevant data to inform pricing recommendations and financial decisions.
• Direct the development, maintenance, and use of pricing models, risk evaluation models, and client profitability models used to evaluate prospective and current client opportunities.
• Evaluate pricing risk, financial guarantee exposure, and value derived from client relationships to support balanced recommendations aligned with Navitus’ financial, strategic, and client retention objectives.
• Maintain and apply underwriting guidelines, pricing standards, approval processes, policies, procedures, work instructions, and quality assurance practices to support consistent, compliant, and well-documented pricing decisions.
• Participate in client-facing meetings, finalist presentations, and internal strategy discussions by communicating pricing approach, financial risk, and business value to technical and non-technical audiences.
• Support periodic leadership reporting on pricing, underwriting, client profitability, business value, risk exposure, actual-to-expected performance, and related performance metrics.
• Identify and implement process improvements, model enhancements, reporting improvements, training opportunities, and quality assurance practices to increase accuracy, efficiency, consistency, and business value.
• Establish, mentor, and develop team members through coaching, feedback, and career planning, ensuring a pipeline of future leaders and a culture of accountability and growth.
• Other duties as assigned.

Qualifications

• Bachelor’s degree, preferably in Statistics, Mathematics, Finance, Actuarial Science, Economics, Risk Management, or Business, required.
• 4+ years of pricing and/or underwriting experience in pharmacy benefit management, managed care, or adjacent setting required.
• 2+ years of progressive leadership experience, which may include leading individual contributors or teams, or equivalent leadership experience such as coaching, mentoring, or leading complex initiatives or projects, required.
• Experience working in the pharmacy benefit management industry preferred.
• Experience using financial valuation models and analyzing results preferred.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

Benefits

• Top of the industry benefits for Health, Dental, and Vision insurance
• 20 days paid time off
• 4 weeks paid parental leave
• 9 paid holidays
• 401K company match of up to 5% - No vesting requirement
• Adoption Assistance Program
• Flexible Spending Account
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program – up to $750!