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city

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<h3>Job Description</h3>
Actuary - Worksite Life Pricing &amp; Product Management
Health and Worksite Product Team
Full-Time
Springfield, MA or Boston, MA
The Opportunity
MassMutual Health and Worksite Product organization is looking for a career ASA or a new FSA to work on Worksite Life product pricing and product development. At MassMutual, we’re passionate about helping all Americans find financial security, and this passion drives us to continually improve our suite of products. As a Worksite Life Pricing and Product Management Actuary on the Health and Worksite Product team you will get a chance to develop, implement and manage market-leading life products and benefits in a fast paced, innovative, and collaborative environment.&nbsp;
The Team
The Health and Worksite Product team is focused on developing new and managing existing Participating Whole Life, UL and VUL products. We are responsible for ensuring that our new products are market leaders, while ensuring healthy margins by overseeing the dividends and non-guaranteed elements within the products. We are relied upon by the leadership to derive Worksite product strategy to profitably grow our business and for providing superior actuarial support to our Worksite business partners.
The Impact
The candidate will become a subject matter expert for our Worksite life insurance products. The individual will support or lead cross-functional initiatives to bring new products to the market. The candidate hired for this position will:
<ul>
<li>
Learn about the Worksite market and the latest innovations in this space
</li>
<li>
Develop insight into the inner workings of the insurance carrier via collaboration with other areas such as IT, Underwriting, Operations, Marketing, Sales support, and others
</li>
<li>
Design, price, implement and manage Worksite UL, VUL and Participating Whole Life products to fuel the growth of our Worksite business
</li>
<li>
Identify risks inherent in new and current product design and develop strategies and processes to manage and mitigate such risks
</li>
<li>
Form opinions, make recommendations, and drive decisions and execution
</li>
<li>
Build and enhance Microsoft Excel and Moody’s Axis models to calculate pricing for new products or to calculate profitability and sensitivity analysis for our in-force block.
</li>
<li>
Work with the cross-functional product implementation teams to ensure accurate product build across the administration platforms
</li>
<li>
Provide actuarial and product expertise support to other teams across the Worksite departments, such as IT, Operations, Underwriting, and Sales
</li>
<li>
Build a deep understanding of Worksite business, generate insights from the data and present complex analysis in a simple and straightforward manner to key business partners.
</li>
<li>
Monitor the profitability of the products and support the critical product management processes of the annual dividend analysis, illustration regulation testing, NY210 and SIA reports
</li>
<li>
Comply with Actuarial Standards of Practice, Code of Professional Conduct and company standards
</li>
</ul>
The Minimum Qualifications
<ul>
<li>
Bachelor’s Degree in Mathematics, Finance or Computer/Data Science, Actuarial Science, or related field
</li>
<li>
Career ASA
</li>
<li>
5+ years of actuarial experience
</li>
</ul>
The Ideal Qualifications
<ul>
<li>
Fellow of the Society of Actuaries (FSA)
</li>
<li>
5+ years of actuarial experience with a focus on Life Insurance
</li>
<li>
Experience with Group Life Insurance
</li>
<li>
Experience with product pricing &amp; product development
</li>
<li>
Proficiency with Microsoft Excel and Moody’s Axis
</li>
<li>
Proven ability to independently drive and lead cross-functional projects
</li>
<li>
Innovative, self-motivated, and independent with strong analytical, critical thinking, actuarial, and communication skills
</li>
<li>
Comfortable dealing with both complexity and ambiguity, and able to explore multiple solutions to problems and challenges
</li>
<li>
Continuous improvement mindset and willing to challenge the status quo
</li>
<li>
Ability to build and maintain strong working relationships across cross-functional groups
</li>
<li>
Ability to convey complex issues, explain methodologies, and influence resolutions in writing and orally to a variety of audiences
</li>
<li>
Effective time management, planning and organization skills
</li>
</ul>
What to Expect as Part of MassMutual and the Team
<ul>
<li>
Regular meetings with the Worksite Heath and Life product team, Corporate Oversight and ERM teams
</li>
<li>
Focused one-on-one meetings with your manager
</li>
<li>
A company committed to helping you advance your professional development goals
</li>
<li>
Twice yearly company-sponsored internal actuarial event to support networking and CPD
</li>
<li>
Access to mentorship opportunities and to learning content on Degreed and other informational platforms
</li>
<li>
Networking opportunities including access to Asian, Hispanic/Latinx, African American, women, LGBTQ, Veteran and disability-focused Business Resource Groups
</li>
<li>
Your ethics and integrity will be valued by a company with a strong and stable ethical business with industry leading pay and benefits
</li>
</ul>
#LI-ST1
MassMutual is an equal employment opportunity employer. We welcome all persons to apply. If you need an accommodation to complete the application process, please contact us and share the specifics of the assistance you need.

Actuary - Worksite Life Pricing & Product Management

<h3>Job Description</h3>
Job Description
Senior Property &amp; Casualty Actuary
Join our collaborative team where your actuarial expertise will directly influence company-wide strategy and performance. Stillwater Insurance Group is seeking a Senior Property &amp; Casualty Actuary to serve as a trusted partner to the CEO and leadership team. This highly visible role provides the opportunity to work across multiple lines—Auto, Home, and Commercial—where your insights will shape pricing, reserving, product development, and analytical initiatives nationwide. Enjoy the autonomy and impact of a smaller company, with the support and stability of a national carrier.
Why Stillwater?
Stillwater Insurance Group is a national, admitted, AM Best and Demotech rated, mid-sized P&amp;C insurance company offering a variety of home, auto, and commercial insurance products across all 50 states. We are headquartered in Jacksonville, Florida, with additional offices in New York and Omaha, Nebraska. As a leading national carrier, we are proud to provide insurance solutions nationwide, with a strong reputation for stability and service. This is an in-office position located in Jacksonville, FL.
At Stillwater, our employees consistently describe us as a great company with great people, where honesty and integrity are top priorities. As a team member, you will have the opportunity to make a difference every day, contribute to the company's growth, and engage with emerging technologies. With a focus on coaching, development, recognition, and professional growth, we offer the advantages of working in a small, collaborative team environment—backed by the resources and reach of a national carrier.
Role Overview
The Senior Property &amp; Casualty Actuary will report directly to the President/CEO and work across multiple business lines, including Auto, Home, and Commercial. The role encompasses a broad set of responsibilities such as modeling, pricing, product development, reserving, and analytics. You’ll collaborate cross-functionally across departments to ensure alignment with company goals and support data-driven decision-making at the executive level.
Duties and Responsibilities
<ul>
<li>Use RMS and AIR modeling software to develop and refine catastrophe by-peril pricing.</li>
<li>Provide actuarial analysis and guidance to support key strategic and tactical decisions.</li>
<li>Deliver forecasts for exposures, premiums, insured values, and losses to support risk management, reinsurance, and budgeting efforts.</li>
<li>Support and guide ratemaking and reserving processes.</li>
</ul>
Qualifications
<ul>
<li>Bachelor’s degree in Actuarial Science, Mathematics, Statistics, or a related field.</li>
<li>FCAS or ACAS designation; must be a member of the American Academy of Actuaries.</li>
<li>Deep knowledge of personal and commercial insurance pricing strategies.</li>
<li>Experience in statistical modeling and data mining within a P&amp;C context.</li>
<li>Proficiency with Microsoft Office tools (especially Excel, Word, PowerPoint, and Outlook).</li>
<li>Ability to analyze complex issues, use critical thinking to develop solutions, and communicate results to both technical and non-technical audiences.</li>
<li>Proven ability to manage multiple projects and meet deadlines with strong attention to detail.</li>
<li>Hands-on experience working with data tools and modeling software (RMS/AIR preferred).</li>
</ul>
Stillwater Offers:
<ol>
<li>Business casual work environment – wear your jeans to work!</li>
<li>Office location near I-95 and Butler Blvd. – convenient for shopping and dining.</li>
<li>Medical, dental, vision, and life insurance benefits to keep you and your family protected.</li>
<li>401(k) Plan to help you plan for your retirement with Employer Match.</li>
<li>Gym/Fitness Center reimbursement to support your commitment to staying healthy.</li>
<li>Generous Paid Time Off (PTO) program to help you maintain your work/life balance.</li>
<li>Relocation assistance is available.</li>
</ol>
Apply today to start your journey of being celebrated and valued with Stillwater Insurance Group.
Our offer is contingent upon a favorable response from both a pre-employment background investigation and a drug screen.
Stillwater Insurance Group is an equal opportunity employer and a drug-free workplace.

Senior Property & Casualty Actuary - Jacksonville, FL

<h3>Job Description</h3>
Job Description
The main purpose of the role is to Underwrite existing and new programs with oversite from the Vice President, Specialty Product Underwriting. The underwriter will also provide general support to the Underwriting functions and Specialty Team.
Minimum Qualifications:
<ul>
<li>Bachelor’s Degree or 4 years of commercial underwriting experience.</li>
<li>4 years’ experience with an insurance company or reinsurance company</li>
<li>Excess and Surplus Lines experience is a plus.</li>
<li>Must have strong communication skills to build and leverage excellent customer relationships.</li>
<li>Must be able to market products and services.</li>
<li>Must have strong hands-on experience with various computer systems.</li>
<li>Completion of or progression toward Chartered Property Casualty Underwriter (CPCU) designation is a plus.</li>
<li>Understanding of the back-office function of portfolio management</li>
<li>Some experience in Underwriting a wide range of business, including property and liability risks.</li>
</ul>
Primary Job Functions:
<ul>
<li>Responsible for Risk selection
<ul>
<li>Rejection</li>
<li>Pricing</li>
<li>Retention</li>
<li>Growth and profitability focused.</li>
</ul>
</li>
<li>
Analyzes coverage and limit requests and decides what terms to offer.
</li>
<li>
Prices business to ensure profitability.
</li>
<li>
Ensures appropriate reports are used for reporting to Fortegra.
</li>
<li>
Develops and maintains effective business relationships with internal and external customers, coworkers, including Reinsurers, Actuary, Marketing, IT and Claims
</li>
<li>
Interpret, explain, and market services and products.
</li>
<li>
Develops relationship with agents and brokers.
</li>
<li>
Applies underwriting rules and guidelines, rating manual rules and insurance laws and regulations.
</li>
<li>
May need to provide guidance and assistance to other team members.
</li>
<li>
Monitor the progress of each program to ensure maximum profitability is achieved.
</li>
<li>
Performs other duties as assigned.
</li>
</ul>
The above cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job. They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform.
Skills &amp; Competencies Required:
<ul>
<li>Requires some knowledge of a specialized function or skill</li>
<li>Developing real trade craft and skills</li>
<li>Excellent portfolio management skills</li>
<li>Strong project management skills</li>
<li>Good presentation skills</li>
<li>Attention to detail</li>
<li>Trustworthy, loyal, honesty and integrity</li>
<li>Team player</li>
<li>Results driven</li>
<li>Entrepreneurial mindset</li>
<li>People orientated</li>
<li>Perseverant and hard working</li>
<li>Highly motivated and takes responsibility for actions and results</li>
</ul>

Director Specialty Underwriting

<h3>Job Description</h3>
Zurich is currently looking to hire an experienced E&amp;S Property Underwriter to join the team in our Atlanta office. We will also consider having someone in our Chicago office. In this role you will be working with national wholesalers to drive growth with a focus on profitability. As an E&amp;S Property Underwriter you will serve as a leader and mentor to the team offering technical guidance on key coverage issues and forms.
This is a great opportunity for someone who wants to grow and develop their coaching and mentoring skills.
Zurich E&amp;S is dedicated 100% to a wholesale distribution model and a product and technology strategy designed to make Zurich a market leader in E&amp;S, as measured by gross written premium, profitability, and employee satisfaction!
This role will be filled at either an AVP, Underwriting Director OR VP, Senior Underwriting Director level. The hiring manager will determine the appropriate level based upon the selected applicant’s experience and skillset relative to the qualifications listed for this position.
What you can expect in an E&amp;S Property Underwriting position at Zurich:
<ul>
<li>You will develop and maintain relationships with broker partners and customers across all industries in support of business objectives&nbsp;&nbsp;</li>
<li>You will leverage your property underwriting acumen across risk assessment, exposure evaluation and pricing to generate and maintain a profitable book of new and renewal business.&nbsp;</li>
<li>You will work collaboratively across business units including but not limited to; claims, finance, risk engineering, actuary, and technical underwriting while gaining extensive knowledge in a growing and innovative industry.&nbsp;&nbsp;&nbsp;</li>
<li>You will be empowered to use your market facing, negotiation and interpersonal skills to grow and develop relationships with preferred distribution partners in an assigned territory&nbsp;</li>
</ul>
AVP, Underwriting Director Qualifications:
<ul>
<li>High School Diploma or Equivalent and 7 or more years of experience in the Underwriting or Market Facing area OR</li>
<li>High School Diploma or Equivalent and 14 or more years of experience in the Claims or Underwriting Support area OR</li>
<li>Zurich Certified Insurance Apprentice including an Associate Degree and 5 or more years of experience in the Underwriting or Market Facing area OR</li>
<li>Zurich Certified Insurance Apprentice including an Associate Degree and 12 or more years of experience in the Claims or Underwriting Support area</li>
</ul>
OR&nbsp;
VP, Senior Underwriting Director Qualifications:
<ul>
<li>Bachelor’s Degree and 9 or more years of experience in the Underwriting or Market &nbsp;&nbsp;Facing area. OR</li>
<li>Bachelor’s Degree and 18 or more years of experience in the Claims or Underwriting Support area OR</li>
<li>***Only current employees at reward level 7 and above may apply with a High School Diploma or Equivalent and 10 or more years of experience*** AND</li>
<li>Experience in Excess &amp; Surplus Property Underwriting</li>
</ul>
Preferred Qualifications:
<ul>
<li>Bachelor’s Degree</li>
<li>9 or more years of experience in E&amp;S Property underwriting, familiar with offering smaller limits on quota shared and layered business for hard to place accounts</li>
<li>Strong Wholesale broker relationships</li>
<li>Strong verbal and written communication skills</li>
</ul>
At Zurich, compensation for roles is influenced by a variety of factors, including but not limited to the specific office location, role, skill set, and level of experience. In compliance with local laws, Zurich commits to providing a fair and reasonable compensation range for each role. For more information about our Total Rewards, please click here. Additional rewards may encompass short-term incentive bonuses and merit increases. We encourage candidates with salary expectations beyond the provided range to apply as they will be considered based on their experience, skills, and education. The compensation indicated represents a nationwide market range and has not been adjusted for geographic differentials pertaining to the location where the position may be filled. The combined salary range for this position is $130,000.00 - $280,000.00. The proposed salary range for the AVP is $130,000.00 - $215,000.00, with short-term incentive bonus eligibility set at 20%. The proposed salary range for the VP is $175,000.00 - $280,000.00, with short-term incentive bonus eligibility set at 20%. 
As an insurance company, Zurich is subject to 18 U.S. Code § 1033.
A future with Zurich. What can go right when you apply at Zurich?
Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please click here to learn more.
Zurich in North America is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.&nbsp;
Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission.&nbsp;
Location(s): AM - Atlanta, AM - Chicago Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered:&nbsp;No&nbsp;&nbsp; &nbsp; Linkedin Recruiter Tag: #LI-WL1 #LI-DIRECTOR #LI-HYBRID&nbsp;

AVP, Underwriting Director OR VP, Senior Underwriting Director- E&S Property

<h3>Job Description</h3>
Job Description
Job Information
Job Title
Insurance Product Technical Manager
Home Department:
Insurance Product
Employment Status:
Exempt; Full-time
Schedule:
40 hours/week with Flexible Scheduling Opportunities&nbsp;
Position Location:
Corporate office, Hybrid, or Remote Worker

This position offers flexible remote/hybrid work scheduling and we are targeting candidates who are located within the 9 states which Society conducts business in. Visit us at&nbsp;<a href="https://societyinsurance.com/" target="_blank">https://societyinsurance.com/</a> to learn more.

Overview
Protecting our policyholders’ dreams, passions, and livelihoods has a direct impact on the communities we serve. We work towards excellence, conduct ourselves with high integrity, and take our work seriously, but not ourselves. Small Details. Big Difference. Find out how you can make a difference with a career at Society.
We’re excited to share the creation of a brand-new position at Society Insurance – Insurance Product Technical Manager – a role designed to bridge the gap between product development, underwriting, operations, and technology. &nbsp;The Insurance Product Technical Manager plays a pivotal role in the product management lifecycle by overseeing the technical integrity, regulatory compliance, and operational efficiency of insurance products across the organization. &nbsp;This position leads three specialized teams – Product Maintenance, User Acceptance Testing (UAT), and Regulatory &amp; Statistical Reporting – to ensure products are accurately maintained, thoroughly tested, and fully compliant with industry standards and government regulations. &nbsp;In short – this position is at the heart of how we connect insurance expertise with technology execution, helping us serve our agents, partners, and policyholders more effectively.&nbsp;
About the Role&nbsp;
<ul>
<li>Uses a strong understanding of underwriting, claims, actuary, and sales that enables them to effectively contribute to decision making and execution.</li>
<li>Navigates ISO (Insurance Services Office), NCCI (National Council on Compensation Insurance) and works with maintaining currency, leveraging ISO / NCCI base, circulars, ERC (Electronic Rating Content), etc.</li>
<li>Demonstrates a holistic view of the systems, processes, and applications they support.</li>
<li>Product Maintenance Team Leadership:
<ul>
<li>Oversees ongoing updates and configurations of insurance products within internal systems.</li>
<li>Ensures product definitions, rates, rules, and forms are accurately implemented and maintained.</li>
<li>Collaborates with actuarial, underwriting, and IT teams to support product lifecycle changes.</li>
</ul>
</li>
<li>User Acceptance Testing (UAT) Team Leadership:
<ul>
<li>Leads the planning, execution, and documentation of UAT for new and updated insurance products.</li>
<li>Develops test strategies and scripts to validate system functionality and business requirements.</li>
<li>Coordinates cross-functional testing efforts and ensure timely resolution of defects.</li>
</ul>
</li>
<li>Regulatory &amp; Statistical Reporting Team Leadership:
<ul>
<li>Ensures timely and accurate submission of regulatory filings and statistical reports.</li>
<li>Monitors changes in state and federal insurance regulations and implement necessary updates.</li>
<li>Liaise with product, compliance and legal teams to interpret reporting requirements and maintain audit readiness.</li>
<li>Completes necessary administrative work by (including but not limited to) approving timecards; approving PTO and flextime requests, and completing yearly salary administration.&nbsp;</li>
</ul>
</li>
</ul>
About You&nbsp;
<ul>
<li>You enjoy coaching and developing others.</li>
<li>You are decisive and make rational fact-based decisions.&nbsp;</li>
<li>You motive others to achieve and exceed business goals.</li>
<li>You clearly communicate expectations and empowers others to take responsibility.</li>
<li>You inspire commitment and foster an alignment with organizational goals and values.</li>
<li>You take a systematic approach in streamlining workflows to improve efficiency, effectiveness, and adaptability.&nbsp;</li>
</ul>
What it Will Take
<ul>
<li>Bachelor’s degree in a business-related field or an associate’s degree in insurance, business, or related field, or equivalent experience holding positions with increasing responsibilities.</li>
<li>7-10 years of Property and Casualty insurance industry experience.</li>
<li>Experience in a leadership role, such as a team lead or similar position demonstrating the ability to inspire and motivate others, provide mentorship, and guide teams toward achieving common goals. &nbsp;</li>
<li>Expertise in commercial P&amp;C insurance products and policy construction, including coverage structure and rating/pricing plans.&nbsp;</li>
<li>Experience with ISO, NCCI, and working with maintaining currency, leveraging ISO / NCCI base, circulars, ERC, etc.</li>
<li>Experience working within a SAFe agile environment to deliver and manage products.</li>
<li>Strong analytical skills to conduct results reviews on the performance of existing and new products.</li>
<li>3+&nbsp;years of management or supervisory experience highly desirable.</li>
<li>Strong understanding of insurance systems, product configuration, and compliance frameworks highly desirable.</li>
<li>Additional insurance education and designation work (CPCU or other related insurance designations) are highly desirable.</li>
</ul>
What Society Can Offer&nbsp;
<ul>
<li>Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and vision insurance</li>
<li>Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan</li>
<li>Work-Life Balance: Company-paid holidays; flexible scheduling; PTO; telecommuting options</li>
<li>Education: Career Coaching; company-paid courses; student loan and tuition reimbursement</li>
<li>Community: Charitable Match; paid volunteer time; team sponsorships</li>
<li>Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more</li>
</ul>
Society Insurance prohibits discrimination and harassment of any type against applicants and employees on the basis of race, color, religion, sex, national origin, age, handicap, disability, genetics, veteran status or military service, marital status or sexual orientation, gender identity or expression, or any other characteristic or status protected by federal, state or local laws. Society Insurance also provides reasonable accommodations to qualified individuals with disabilities in accordance with the requirements of the Americans with Disabilities Act and applicable state and local laws.
 
PIc00500876570-25405-38859167

Insurance Product Technical Manager

<h3>Job Description</h3>
Job Description
Let’s do great things, together!
About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.
 Position Summary We are currently seeking a skilled and dedicated pharmacist to join our clinical pharmacy team. In this role, you will have the exciting opportunity to focus on the vital prior authorization functions of our work. Your primary responsibilities will involve making coverage determinations and completing appeal requests, using your clinical expertise to provide coverage decisions based on established criteria, guidelines, and specific plan design. By joining our team, you will be part of a dynamic environment where you can make a significant impact on patient care and contribute to the overall success of our healthcare organization. This is FT WFH position. 
Pay Range
$101,855.89 - $129,864.20 (depending on experience) *This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.
 Please fill out an application on our company page, linked below, to be considered for this position.
<a href="https://j.brt.mv/jb.do?reqGK=27766012&amp;refresh=true" target="_blank">https://j.brt.mv/jb.do?reqGK=27766012&amp;refresh=true</a>
 Benefits:
<ul>
<li>Medical, Dental, Vision, Pharmacy, Life, &amp; Disability</li>
<li>401K- Matching</li>
<li>FSA</li>
<li>Employee Assistance Program</li>
<li>PTO and Company Paid Holidays</li>
</ul>
 Required Skills, Experience &amp; Education:
<ol>
<li>Current active and unrestricted Oregon Registered Pharmacist license, or eligible for Oregon licensure which is to be obtained within 60 days of hire date</li>
<li>Effective communication and interpersonal skills to interact with healthcare providers, internal teams, and external stakeholders</li>
<li>Commitment to service, organizational values, and professionalism through appropriate conduct and demeanor always</li>
<li>Works well under pressure with frequent interruptions and shifting priorities</li>
<li>Follow the company HR policies, Code of Conduct, and all department policies and procedures including protecting confidential company, employee, and customer information</li>
</ol>
Preferred Skills
<ol>
<li>Doctor of Pharmacy degree (Pharm.D.)</li>
<li>Experience in clinical therapeutics for specialty drugs </li>
<li>Two to three years of managed care experience</li>
</ol>
Primary Functions:
<ol>
<li>Evaluate medication requests for coverage (e.g., prior authorization reviews, non-formulary requests, step therapy exceptions), conducting thorough clinical reviews and assessing their compliance with established clinical guidelines, formularies, and policies</li>
<li>Provide prior authorization pharmacist coverage for rotating weekends and holidays</li>
<li>Provide ad hoc or on call support for urgent medication requests and provide internal pharmacist support to the pharmacy team, appeals unit, and customer services department</li>
<li>Perform coverage determination reviews for all lines of business (i.e., commercial, exchange, government) for pharmacy and medical (physician-administered or home infusion) medications</li>
<li>Participate in the appeals and grievances process by providing clinical expertise and reviewing medication-related appeals and complaints</li>
<li>Complete medical literature evaluation using primary, secondary, and tertiary drug resources to support coverage decision-making and recommendations </li>
<li>Perform peer-to-peer reviews with providers when requested </li>
<li>Make recommendations on medication edit improvements (e.g., programming) and coverage criteria, based on utilization and findings during coverage determination reviews</li>
<li>Provide clear, comprehensive, and timely responses to requests for drug information to members, clients, providers, and internal staff via detailed and thorough documentation within coverage determinations, appeal documentation, and email inquiries</li>
<li>Organize workload, set priorities, complete assignments in a timely manner and utilize resources appropriately while complying with department program standards</li>
<li>Participate in and support department quality assurance and ongoing improvement practices</li>
<li>Remain current on all communications and updated processes relayed through multiple team communication channels and apply to daily duties and responsibilities</li>
<li>Support staff training and development as required</li>
<li>Review, update, and maintain applicable policies and procedures related to clinical pharmacy services </li>
<li>Performs all other related duties as assigned by departmental managers</li>
</ol>
 Working Conditions &amp; Contact with Others
<ul>
<li>Remote, office environment, and/or hybrid with extensive close PC and keyboard work, and constant sitting. Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business needs. May require occasional travel to conferences or offsite business meetings.</li>
<li>Internally with Clinical Pharmacy, Analytics, Marketing, Sales &amp; Account Services, Actuary &amp; Underwriting, Healthcare Services, Medicare and Medicaid Programs, Benefits, Legal, Regulatory Affairs, and Compliance. Externally with PBM, medical management vendor, pharmaceutical and biotechnology manufacturers, consultants and benefit managers, clients, providers, and pharmacists.</li>
</ul>
Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler &amp; Danielle Baker via our <a href="mailto:humanresources@modahealth.com" target="_blank">humanresources@modahealth.com</a> email.

Prior Authorization Pharmacist

<h3>Job Description</h3>
Job Description
Let’s do great things, together!
About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.
 Position Summary We are seeking a Manager of Pharmacy Business Development with a focus on industry relations. The domain expertise to be successful in this role requires foundational clinical pharmacy experience, accompanied by a high degree of business acumen, and an interest and passion for partnering closely with pharmaceutical and biotechnology companies, and other vendor partners who engage in contracting opportunities such as rebate management, and clinical programs. Overall, this position is responsible for development of strategic formulary approaches for the management of medications across the medical and pharmacy benefits, driving to low net cost medication utilization. This position includes reviewing rebate initiatives for medications covered under the pharmacy and medical benefits, across various lines of business including commercial, Exchange, Medicare and Managed Medicaid. The role includes facilitating or supporting the implementation of projects or activities with both external and internal stakeholders and articulating this value as necessary. The ideal candidate resides near or within commuting distance of our Portland, Oregon office to support a hybrid work arrangement, however, remote status will also be considered. 
 Pay Range $48,135.39 - $62,573.94 annually (depending on experience) *This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.
 Please fill out an application on our company page, linked below, to be considered for this position.
<a href="https://j.brt.mv/jb.do?reqGK=27766011&amp;refresh=true" target="_blank">https://j.brt.mv/jb.do?reqGK=27766011&amp;refresh=true</a>
 Benefits:
<ul>
<li>Medical, Dental, Vision, Pharmacy, Life, &amp; Disability</li>
<li>401K- Matching</li>
<li>FSA</li>
<li>Employee Assistance Program</li>
<li>PTO and Company Paid Holidays</li>
</ul>
 Required Skills, Experience &amp; Education:
<ol>
<li>Doctor of Pharmacy degree (Pharm.D.) preferred, or Bachelors of Pharmacy degree.</li>
<li>Current active and unrestricted Oregon Registered Pharmacist license, or eligible for Oregon licensure which is to be obtained within 60 days of employment. </li>
<li>Past supervisory experience managing a team.</li>
<li>Three to five years of managed care experience, time can be inclusive of training from an accredited managed care residency program.</li>
<li>Experience with Commercial, Medicare, and/or Medicaid lines of business.</li>
<li>Experience managing contracts, particularly with biopharmaceutical manufacturers and other pharmacy vendors.</li>
<li>Technical understanding of pharmacy claims processing information and systems.</li>
<li>Strong analytical skills and business acumen.</li>
<li>Ability to communicate and present technical information appropriate for the audience.</li>
<li>Ability to work independently and collaborate cross-functionally with various stakeholders.</li>
<li>Project management skills and the ability to plan and execute projects as assigned.</li>
<li>Commitment to service, organization values, and professionalism.</li>
<li>Ability to maintain confidentiality and project a professional business image.</li>
<li>Works well under pressure with frequent interruptions and shifting priorities.</li>
<li>Ability to work independently.</li>
<li>Proficient with Microsoft Office applications such as Word, Excel, Outlook, and PowerPoint.</li>
</ol>
Primary Functions:
<ol>
<li>Lead industry relations and rebate strategies for medical and pharmacy benefit medications, and new and emerging therapies, across all lines of business.</li>
<li>Oversee all rebate partners and lead evaluations of new potential partners.</li>
<li>Identify and negotiate direct contracts with biopharmaceutical partners.</li>
<li>Identify, manage, and assess the value of unique vendor partnerships to advance pharmacy programs, including drug information resources, medical management organizations, digital therapeutics, and point of service solutions.</li>
<li>Responsible for ensuring compliance with rebate contracts, rebate terms within client contracts, and contracts held with other vendor partners.</li>
<li>Lead rebate modeling and optimize rebate scenarios and bid selections based on client specific goals and strategies.</li>
<li>Oversee pipeline developments, including market events and material changes to therapeutic categories, for new and emerging therapies, specialty, and traditional medications, and keeps internal and external stakeholders apprised of such events. Develops educational materials as needed.</li>
<li>Leads custom formulary rebate offerings and recommendations for downstream clients.</li>
<li>In collaboration with other pharmacy leaders, develop enterprise-wide industry relations strategy.</li>
<li>Oversee, develop and manage Moda’s Industry Relations team.</li>
<li>Lead rebate offerings for existing therapeutic strategies which support ongoing formulary performance, but also identify new opportunities either as contracting changes or new market entrants are FDA-approved.</li>
<li>Work closely with vendor partners (PBM, medical management companies, others) on policy or formulary changes driven by cost analysis, including rebate considerations or contracting.</li>
<li>Support and/or lead client facing presentations within industry relations as necessary.</li>
<li>Responsible for information gathering with legal and/or regulatory teams to understand impact to current formulary strategies, with financial implications, to anticipate or plan for any potential compliance driven update due to changes in existing, or new and emerging states of business. </li>
<li>Monitor, anticipate changes, and prepare for pipeline and market events.</li>
<li>Develop concise, applicable, comprehensive, and timely communiques as assigned for members, providers, internal, or external stakeholders.</li>
<li>Provide clinical support services that intersect industry relations or business development, including but not limited to benefit design, formulary analysis, drug information, P&amp;T participation, client support, and drug utilization management.</li>
<li>Contribute, update, and maintain policies and procedures related to industry relations. </li>
<li>Complete significant projects and performs all other related duties as assigned.</li>
<li>Follow the company HR policies, Code of Conduct, and all department policies and procedures including protecting confidential company, employee, and customer information. </li>
</ol>
 Working Conditions &amp; Contact with Others
<ul>
<li>Remote, office environment, and/or hybrid with extensive close PC and keyboard work, and constant sitting. Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business needs. May require occasional travel to conferences or offsite business meetings.</li>
<li>Internally with Clinical Pharmacy, Analytics, Marketing, Sales &amp; Account Services, Actuary &amp; Underwriting, Healthcare Services, Medicare and Medicaid Programs, Benefits, Legal, Regulatory Affairs, and Compliance. Externally with PBM, medical management vendor, pharmaceutical and biotechnology manufacturers, consultants and benefit managers, clients, providers, and pharmacists.</li>
</ul>
Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler &amp; Danielle Baker via our <a href="mailto:humanresources@modahealth.com" target="_blank">humanresources@modahealth.com</a> email.

Manager, Pharmacy Business Development

<h3>Job Description</h3>
Job Description
*Position coming up in November*
 
Customer service order processing experience in a call center or supplier/office. Call center environment or&nbsp;in home improvement industry order processing, special order desk, or similar experience in a telephone customer service role. 
 
18months or more experience, Competent using MS Outlook, Excel, and Word. Touch typing at 35wpm and above. Ability to multi-task is essential.
 
Excellent phone skills to handle inbound/outbound calls. Assist customers with order status, delivery assistance, special orders, and troubleshooting. 
 
Company trains for this position for a few weeks, and regular, punctual attendance is needed. M-F 8a-5p with 1 hour overtime on Wednesday mornings (7am start each Wednesday) May be asked to work occasional Saturdays.
 
<ul>
<li>Quote processing &amp; follow-up</li>
<li>Order input</li>
<li>Shipment tracking and updating</li>
<li>Outbound update calls to customers</li>
<li>Proficient using spreadsheets</li>
</ul>
Temporary-to-hire position.
 
$19.25/hr to start, up to $20 once hired w/benefits. After 90 days, you will have the opportunity to learn products lines with pay increases to your hourly wage, between .25c-$1.25/hour upon passing a written and actuary test.
 
High diploma/GED or equivalent, background check when being hired as a regular employee

Call Center Rep/Customer Service Quotes & Order Processing

<h3>Job Description</h3>
Job Description
Job Information
Job Title
Insurance Product Technical Manager
Home Department:
Insurance Product
Employment Status:
Exempt; Full-time
Schedule:
40 hours/week with Flexible Scheduling Opportunities&nbsp;
Position Location:
Corporate office, Hybrid, or Remote Worker

This position offers flexible remote/hybrid work scheduling and we are targeting candidates who are located within the 9 states which Society conducts business in. Visit us at&nbsp;<a href="https://societyinsurance.com/" target="_blank">https://societyinsurance.com/</a> to learn more.

Overview
Protecting our policyholders’ dreams, passions, and livelihoods has a direct impact on the communities we serve. We work towards excellence, conduct ourselves with high integrity, and take our work seriously, but not ourselves. Small Details. Big Difference. Find out how you can make a difference with a career at Society.
We’re excited to share the creation of a brand-new position at Society Insurance – Insurance Product Technical Manager – a role designed to bridge the gap between product development, underwriting, operations, and technology. &nbsp;The Insurance Product Technical Manager plays a pivotal role in the product management lifecycle by overseeing the technical integrity, regulatory compliance, and operational efficiency of insurance products across the organization. &nbsp;This position leads three specialized teams – Product Maintenance, User Acceptance Testing (UAT), and Regulatory &amp; Statistical Reporting – to ensure products are accurately maintained, thoroughly tested, and fully compliant with industry standards and government regulations. &nbsp;In short – this position is at the heart of how we connect insurance expertise with technology execution, helping us serve our agents, partners, and policyholders more effectively.&nbsp;
About the Role&nbsp;
<ul>
<li>Uses a strong understanding of underwriting, claims, actuary, and sales that enables them to effectively contribute to decision making and execution.</li>
<li>Navigates ISO (Insurance Services Office), NCCI (National Council on Compensation Insurance) and works with maintaining currency, leveraging ISO / NCCI base, circulars, ERC (Electronic Rating Content), etc.</li>
<li>Demonstrates a holistic view of the systems, processes, and applications they support.</li>
<li>Product Maintenance Team Leadership:
<ul>
<li>Oversees ongoing updates and configurations of insurance products within internal systems.</li>
<li>Ensures product definitions, rates, rules, and forms are accurately implemented and maintained.</li>
<li>Collaborates with actuarial, underwriting, and IT teams to support product lifecycle changes.</li>
</ul>
</li>
<li>User Acceptance Testing (UAT) Team Leadership:
<ul>
<li>Leads the planning, execution, and documentation of UAT for new and updated insurance products.</li>
<li>Develops test strategies and scripts to validate system functionality and business requirements.</li>
<li>Coordinates cross-functional testing efforts and ensure timely resolution of defects.</li>
</ul>
</li>
<li>Regulatory &amp; Statistical Reporting Team Leadership:
<ul>
<li>Ensures timely and accurate submission of regulatory filings and statistical reports.</li>
<li>Monitors changes in state and federal insurance regulations and implement necessary updates.</li>
<li>Liaise with product, compliance and legal teams to interpret reporting requirements and maintain audit readiness.</li>
<li>Completes necessary administrative work by (including but not limited to) approving timecards; approving PTO and flextime requests, and completing yearly salary administration.&nbsp;</li>
</ul>
</li>
</ul>
About You&nbsp;
<ul>
<li>You enjoy coaching and developing others.</li>
<li>You are decisive and make rational fact-based decisions.&nbsp;</li>
<li>You motive others to achieve and exceed business goals.</li>
<li>You clearly communicate expectations and empowers others to take responsibility.</li>
<li>You inspire commitment and foster an alignment with organizational goals and values.</li>
<li>You take a systematic approach in streamlining workflows to improve efficiency, effectiveness, and adaptability.&nbsp;</li>
</ul>
What it Will Take
<ul>
<li>Bachelor’s degree in a business-related field or an associate’s degree in insurance, business, or related field, or equivalent experience holding positions with increasing responsibilities.</li>
<li>7-10 years of Property and Casualty insurance industry experience.</li>
<li>Experience in a leadership role, such as a team lead or similar position demonstrating the ability to inspire and motivate others, provide mentorship, and guide teams toward achieving common goals. &nbsp;</li>
<li>Expertise in commercial P&amp;C insurance products and policy construction, including coverage structure and rating/pricing plans.&nbsp;</li>
<li>Experience with ISO, NCCI, and working with maintaining currency, leveraging ISO / NCCI base, circulars, ERC, etc.</li>
<li>Experience working within a SAFe agile environment to deliver and manage products.</li>
<li>Strong analytical skills to conduct results reviews on the performance of existing and new products.</li>
<li>3+&nbsp;years of management or supervisory experience highly desirable.</li>
<li>Strong understanding of insurance systems, product configuration, and compliance frameworks highly desirable.</li>
<li>Additional insurance education and designation work (CPCU or other related insurance designations) are highly desirable.</li>
</ul>
What Society Can Offer&nbsp;
<ul>
<li>Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and vision insurance</li>
<li>Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan</li>
<li>Work-Life Balance: Company-paid holidays; flexible scheduling; PTO; telecommuting options</li>
<li>Education: Career Coaching; company-paid courses; student loan and tuition reimbursement</li>
<li>Community: Charitable Match; paid volunteer time; team sponsorships</li>
<li>Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more</li>
</ul>
Society Insurance prohibits discrimination and harassment of any type against applicants and employees on the basis of race, color, religion, sex, national origin, age, handicap, disability, genetics, veteran status or military service, marital status or sexual orientation, gender identity or expression, or any other characteristic or status protected by federal, state or local laws. Society Insurance also provides reasonable accommodations to qualified individuals with disabilities in accordance with the requirements of the Americans with Disabilities Act and applicable state and local laws.
 
PIf3a144d4553d-25405-38859167

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