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Navitus Health Solutions

Transparent PBM pass-through rebates for plans

Vice President, Underwriting, Pricing and Analytics

UnderwritingPosted on Nov 11
Full-timeMadison, WI, USANo salary listedIn-person

About the Job

Requirements

  • A bachelor's degree, preferably concentrated in Accounting, Finance, Actuarial Science, Risk Management, or a related field of study, is required.
  • At least 8 years of pricing and/or underwriting experience in Pharmacy Benefit Management, managed care, or an adjacent setting is required.
  • At least 6 years of leadership experience in underwriting, analytics, or financial services is required.
  • Participate in, adhere to, and support compliance program objectives.
  • Consistently interact cooperatively and respectfully with other employees.

Responsibilities

  • Lead selection, project assignments, performance, and development of the pricing and underwriting team.
  • Partner with the divisional Vice President, Chief Finance Officers, Director of Actuary, and other team members responsible for cost accounting, risk assessment, market segment strategy, and product management to inform product and service pricing.
  • Establish and report measures of profitability for product and service portfolios.
  • Use pricing risk assessments conducted by the Chief Actuary and Corporate Underwriting team to facilitate product and service pricing decisions made collaboratively by clinical, financial, and growth team leaders.
  • Ensure pricing decisions appropriately reflect and balance competitive market dynamics, client financial outcomes, and organizational margin.
  • Identify opportunities to leverage technology to automate repetitive pricing and underwriting processes, reducing effort and analysis time and increasing decision speed.
  • Help identify, evaluate, and implement new data-driven strategies and processes for the organization.
  • Continually improve and expand business intelligence value to business users to meet or exceed expectations.
  • Provide analytical and data expertise on content and processes, advising and contributing to a wide variety of business projects.
  • Ensure the Financial Planning Analysis team understands the impact of pricing decisions and future growth to support realistic financial forecasts for organizational strategic planning.
  • Support Sales and Customer Success with service delivery initiatives by conducting analyses and relating findings to business questions and objectives. This may include discussions with clients, consultants, and prospects to communicate value and methodology, integrating information from multiple sources, discerning implications for future analysis, and identifying opportunities for enhancements.
  • Prepare clear, organized, project-specific documentation of analytical methods, key decision points, caveats, and other details sufficient to support comprehension and replication of the analysis.
  • Work with Operating Committee members to identify and address expected and unforeseen data complexities, mitigating their impact on business outcomes and decisions.
  • Support business growth and ongoing corporate strategic planning by performing analytical research to provide management with information and tools for strategic decision-making and planning.
  • Perform other duties as assigned.

About the Company

Navitus Health Solutions

Transparent PBM pass-through rebates for plans

Navitus Health Solutions is a pharmacy benefits manager that offers transparent pricing by passing 100% of negotiated rebates and discounts to its health-plan clients. It runs a spend-management clinical model designed to control drug costs from the outset while supporting member health, delivering both immediate value and long-term savings as drug spend trends are managed over time. The company markets its services through its portfolio brands—Navitus, Lumicera, and Archimedes—and serves over 18 million members across 800 clients, including public and private employers, unions, health plans, and health systems. It is owned by SSM Health and Costco Wholesale Corporation. Unlike traditional PBMs with opaque pricing, Navitus emphasizes transparency and direct savings for plan sponsors. The overarching goal is to reduce prescription drug costs for plans while improving member health outcomes.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Appleton, WI
Founded
2003

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