VP, PBM Underwriting
ABOUT THE ROLE:
The Vice President, PBM Underwriting owns how Rightway prices and renews pharmacy benefits business. You'll lead the underwriting team that turns client data, market conditions, and contract terms into pricing that's competitive, accurate, and sustainable, for both new business and renewals. You'll partner closely with Sales, Finance, Pharmacy, and Client Success to win the right clients and keep them. This is a senior leadership role with real influence on growth.
WHAT YOU’LL DO:
Lead underwriting for new business, RFPs, and renewals
Set underwriting guidelines, approval thresholds, and risk tolerances, and decide when to push back, price for risk, or walk away
Analyze claims and plan data to identify cost drivers, assess risk, and forecast financial performance
Work with Legal, Finance, and Sales on contract terms and guarantees that protect margin while keeping offers competitive
Monitor performance across our book of business against pricing assumptions, and use what you learn to sharpen future pricing and renewal strategy
Partner with the cost of goods, pharmacy network, and rebate teams so pricing reflects real net costs and contract economics
Advocate for Rightway’s pricing models clearly to clients, brokers, consultants, and executive leadership
Build, coach, and develop a high-performing team, and set clear standards for rigor, speed, and documentation
Report on pricing performance, win/loss trends, renewal outcomes, and risk exposure to the executive team
Other duties as assigned
WHO YOU ARE:
10+ years of experience in PBM underwriting, pharmacy pricing, healthcare analytics, or actuarial work, including 5+ years leading teams
Deep knowledge of PBM economics, including rebates, pharmacy network pricing, drug acquisition costs, fee structures, and guarantee design
Strong financial modeling skills and comfort working with large claims datasets (SQL, Excel, and BI tools)
A track record pricing complex, large-employer or consultant-led deals
Sound judgment under uncertainty, with the confidence to make and defend a call
Clear communication, in writing and in the room, with technical and non-technical audiences
Bachelor's degree in finance, actuarial science, economics, pharmacy, or a related field
EXTRA CREDIT:
Actuarial credential (ASA, FSA, or MAAA)
Experience at a PBM, health plan, consultancy, or pharmacy-focused analytics firm
Experience with pass-through or fully transparent pricing models
Experience building underwriting tools or automating pricing workflows
COMPENSATION: $210,000 - $250,000 annually, in addition to bonus and equity
Compensation offered will be determined by geographic location, experience, and qualifications.