Jobs at Prime Therapeutics

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.

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.

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.

The Senior Program Manager leads interoperability programs, ensuring compliance with CMS mandates, driving enterprise alignment, and collaborating across business units to implement operational plans and strategies.

The Senior Provider Relations Analyst manages independent pharmacy networks and contracting activities, ensuring compliance and effective communication between Prime and pharmacies. Responsibilities include resolving inquiries, maintaining contract documents, and collaborating with various stakeholders.

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.

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 Senior Principal Actuary provides actuarial direction, leads pricing initiatives, manages complex data analyses, and influences executive decision-making in a remote role.

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

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

The Business Integration Consultant Principal leads client implementations, manages a team, drives project outcomes, and maintains relationships throughout the project lifecycle.

Responsible for medical review of service requests, interacting with physicians, and ensuring compliance with guidelines in pediatric gastroenterology.

The Sales Executive develops and implements sales strategies to grow membership, leading the pharmacy sales process including proposals and contract negotiations.

The Physician Clinical Reviewer assesses and reviews medical service requests, collaborates with physicians, and ensures compliance with medical guidelines.

The Physician Clinical Reviewer conducts medical reviews of service requests, interacts with healthcare providers, and ensures compliance with medical guidelines.

The Physician Clinical Reviewer-Oncologist provides medical reviews of service requests, interacts with physicians, and assists with utilization management processes.

The Physician Clinical Reviewer evaluates medical necessity for service requests, collaborates with healthcare providers, ensures compliance with guidelines, and assists in training and research activities.

The Physician Clinical Reviewer conducts medical reviews, interacts with healthcare providers, ensures compliance with guidelines, and assists in utilization management decisions.

The Physician Clinical Reviewer evaluates medical service requests, discusses cases with providers, ensures compliance with guidelines, and documents communication accurately.