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Medical and Pharmacy Underwriter and Financial Analyst (Remote)

Medical and Pharmacy Underwriter and Financial Analyst (Remote)

CBIZDublin, OH, US
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Medical & Pharmacy Underwriter

CBIZ, Inc. is a leading professional services advisor to middle market businesses and organizations nationwide. With unmatched industry knowledge and expertise in accounting, tax, advisory, benefits, insurance, and technology, CBIZ delivers forward-thinking insights and actionable solutions to help clients anticipate what's next and discover new ways to accelerate growth. CBIZ has more than 10,000 team members across more than 160 locations in 22 major markets coast to coast.

CBIZ strives to be our team members' employer of choice by creating an environment where team members are appreciated, recognized for their contributions, and provided with opportunities to grow, both personally and professionally, throughout their careers.

About the role : We are seeking a Medical & Pharmacy Underwriter with a strong actuarial background to join our growing team. This role is responsible for evaluating risk, pricing group medical and pharmacy benefit programs, and supporting the development of innovative pricing strategies. The ideal candidate has deep knowledge of healthcare trends, pharmacy cost drivers, and actuarial modeling techniques, with a proven ability to balance risk and competitiveness in pricing decisions.

Essential Functions and Primary Duties

  • Risk Assessment & Underwriting

Review and analyze medical and pharmacy claims experience, demographic data, and plan design details to assess risk.

  • Develop and deliver accurate renewal calculations, new business quotes, and stop-loss evaluations.
  • Collaborate with sales, account management, and product teams to develop competitive pricing strategies.
  • Actuarial Analysis

    • Build, refine, and maintain actuarial models to support pricing and forecasting efforts.

  • Monitor emerging healthcare and pharmacy trends to incorporate into underwriting assumptions.
  • Conduct experience studies and recommend adjustments to rating assumptions as needed.
  • Financial Performance & Reporting

    • Provide insight into book-of-business performance, loss ratios, and trend development.

  • Prepare and present analyses to internal stakeholders and senior leadership.
  • Support financial forecasting and budget-setting initiatives.
  • Collaboration & Compliance

    • Partner with compliance and regulatory teams to ensure adherence to state and federal requirements.

  • Act as a subject-matter expert on risk, pricing methodology, and market competitiveness.

    • Preferred Qualifications

  • Bachelor's Degree in Actuarial Science, Economics, Statistics, or other math-oriented degrees
  • One or more years of underwriting and / or actuarial healthcare experience
  • Two or more actuarial exams passed
  • Must possess analytical skills (mathematics and statistics)
  • 3+ years of experience in medical, pharmacy, or health insurance underwriting.
  • Hands-on experience with actuarial pricing models, trend analysis, and financial forecasting.
  • Familiarity with PBM (Pharmacy Benefit Manager) contracts, formulary management, and specialty drug cost trends is highly desirable.
  • Must be able to comprehend, manipulate, and interpret statistical data
  • Demonstrated ability to communicate verbally and in writing throughout all levels of organization, both internally and externally
  • Experience with SQL, R, Python, VBA, M and SAS or other data analysis tools

    • Minimum Qualifications

  • High School Diploma or GED required
  • Up to 6 years of experience in benefit analysis for group employee benefits
  • Must have the ability to compile, analyze, present, and interpret financial, and statistical information to facilitate decision making
  • Must maintain current required licenses and certifications relevant to the field of expertise
  • Technical knowledge relative to industry and incorporating contract provisions, renewal, and claims processing, plan knowledge, and carrier funding
  • Expertise in managing clients with alternative funding arrangements
  • Advanced skill in using computer application software for financial modeling, statistical analysis, and spreadsheet calculations
  • Expert knowledge of state and federal legislation
  • Sets priorities and manages workflow to ensure efficient, timely, and accurate deliverables
  • Demonstrated ability to communicate verbally and in writing throughout all levels of the organization, both internally and externally
  • Advanced problem-solving and critical thinking skills
  • Must be able to travel based on client and business needs

    • The annual salary target for this job in this market is $75,000 -$85,000. The specific compensation for this role will be determined based on the education, experience, and skill set of the individual selected for this position. The compensation above is not representative of an employee's total compensation. Beyond income, you have access to; comprehensive medical and dental insurance, retirement savings, life and disability insurance, health care and dependent care reimbursement accounts, certification incentives, education assistance, referral programs, and much more. The application window is anticipated to close on or before 10 / 31 / 25.

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    Underwriter • Dublin, OH, US