Jobs at Prime Therapeutics

Lead enterprise claims strategy and multi-year roadmap; drive large-scale initiatives to improve claims technology, operations, and outcomes; develop business cases, prioritize enhancements, manage external partner dependencies, and promote adoption across business units while ensuring alignment with stakeholders and capacity planning.

Research and resolve complex or escalated member issues with compliant, accurate documentation and communications. Act as SME guiding research strategies, validate casework, determine escalations, support reporting, process improvements, and operational performance monitoring.

The AVP of Underwriting leads pricing strategies and client consultations, managing a team to develop competitive pricing and contract language for employer pharmacy business.

The Lead Actuary leads complex pharmacy pricing analyses, provides strategic guidance on pricing, mentors team members, and ensures compliance with regulations.

Lead product delivery for pharmacy claims data solutions: own backlog, translate product discovery into user stories, prioritize features, collaborate with engineering and stakeholders, support sprint ceremonies, monitor feature performance, and ensure product quality and sustainability.

Serve as a senior HR partner providing operational HR support, coaching leaders on employee relations and performance, leading HR projects, advising on org design and talent management, conducting investigations, and partnering with Talent Acquisition for hiring through senior director levels.

Provide tactical legal advice and contracting support to PBM, pharmacy, and government program clients; draft and negotiate commercial agreements; advise on regulatory compliance; provide legal training; coordinate with in-house and outside counsel; investigate and support account management functions.

Build, maintain, and lead complex actuarial and pricing models and data analyses for commercial, Medicare, and Medicaid business; support RFPs, present findings to stakeholders, mentor actuarial staff, and ensure work meets actuarial standards.

The Senior Analyst - Pharmacy Pricing performs pharmacy pricing analyses, analyzes data trends, partners with teams for accurate outputs, and improves processes.

Performs all functions of a registered pharmacist including verifying and processing specialty medication orders, counseling patients and healthcare providers, maintaining pharmacy records, and participating in on-call rotation. Ensures compliance with federal/state laws and company policies, completes required training, and maintains clinical knowledge through continuing education.

Lead state and federal policy strategy for PBM regulatory and legislative matters. Advise executive leadership, produce policy materials, manage advocacy and federal comment filings, represent the company externally, and coordinate cross-functional stakeholder engagement.

Provide tactical HR support to employees, supervisors and managers. Manage employee relations, coach managers on performance and disciplinary actions, partner with Talent Acquisition, assist with job descriptions and compensation reviews, drive performance appraisal processes, participate in HR projects, and handle other HR duties as assigned.