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Navitus Health Solutions

Transparent PBM pass-through rebates for plans

Manager – Pricing and Underwriting

UnderwritingConfirmed live in the last 24 hours
Full-timeRemote in USA$96.5k - $118.4k /yr

About the Job

Requirements

  • A bachelor's degree is required, preferably in Statistics, Mathematics, Finance, Actuarial Science, Economics, Risk Management, or Business.
  • At least 4 years of pricing and/or underwriting experience in pharmacy benefit management, managed care, or an adjacent setting is required.
  • At least 2 years of progressive leadership experience is required; this may include leading individual contributors or teams, coaching, mentoring, or leading complex initiatives or projects.
  • The role requires participating in, adhering to, and supporting compliance program objectives.
  • The role requires consistently interacting cooperatively and respectfully with other employees.

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 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 development, maintenance, and use of pricing models, risk evaluation models, and client profitability models 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 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.
  • Perform other duties as assigned.

Desired Qualifications

  • Experience working in the pharmacy benefit management industry is preferred.
  • Experience using financial valuation models and analyzing results is preferred.

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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