Jobs at Prime Therapeutics

Leads complex enterprise process-improvement and transformation initiatives using Lean Six Sigma. Advises senior leaders, defines future-state operating models, establishes governance and performance dashboards, drives measurable benefits, and coaches practitioners. The role requires advanced data analysis, executive communication, stakeholder management, organizational change leadership, and continuous-improvement expertise across cross-functional business operations.

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.

Supports rebate and client operations by posting payments, mailing dunning letters, maintaining service agreements, reviewing invoices, assisting with billing programs, and fulfilling account management and client reporting requests.

Leads enterprise data and analytics platform operations, service delivery, governance, reliability, compliance, modernization, and continuous improvement. Manages engineers and platform specialists, oversees incidents, upgrades, monitoring, capacity planning, vendor relationships, budgets, and operational metrics. Partners with business and technology leaders on cloud transformation, platform strategy, resource allocation, and executive reporting while developing team talent and ensuring secure, scalable, and sustainable data services.

Leads complex graphic and presentation design projects from concept through execution, ensuring alignment with strategic direction and brand guidelines. Provides creative direction, mentorship, and cross-training to a small design team. Collaborates with marketing leaders and cross-functional partners, presents creative concepts, manages client expectations, and delivers high-quality digital and presentation materials across multiple projects.

Lead actuarial pricing, modeling, and data analyses for PBM clients. Provide strategic pricing advice, manage complex projects, mentor actuarial staff, present findings to stakeholders, and ensure regulatory and actuarial standards compliance.

Leads clinical pharmacy account services for Medicaid PBM clients, overseeing clinical programs, client relationships, implementations, metrics, profitability, and renewals. Partners with account managers and internal teams to identify, sell, implement, and measure clinical solutions that improve care and reduce costs. Mentors clinical liaisons, manages projects and timelines, supports policy requests, resolves complex client issues, and ensures program quality, standardized operations, customer satisfaction, and revenue goals.

Leads enterprise pricing analytics and financial modeling, including forecasting, ROI analysis, financial reporting, pricing and underwriting model standardization, process improvement, client communication, and strategic planning. Manages department staffing, budget, performance, employee development, and cross-functional stakeholders while driving quality and operational transformation across Prime’s pricing and modeling functions.

Leads clinical pharmacy services and account management for Medicaid pharmacy benefit programs. Supervises clinical managers, pharmacists, technicians, and MAC operations staff; oversees client activities, financial objectives, program implementations, performance metrics, quality assurance, regulatory compliance, RFP support, marketing opportunities, and customer service. Requires extensive pharmacy experience, Medicare Part D expertise, marketing experience, and registered pharmacist credentials.

Provides strategic leadership for a trade client relations team supporting pharmacy benefit management clients. Oversees rebate strategy, formulary development, manufacturer contract analysis, financial modeling, client savings opportunities, and implementation support. Manages key client relationships, guides presentations to Pharmacy and Therapeutics committees, supports sales proposals, and collaborates with internal stakeholders to deliver rebate and cost-saving initiatives. Coaches team members and ensures alignment with Prime’s strategic and financial goals.

Leads actuarial pricing, modeling, data analysis, projections, and RFP support for pharmacy benefit business lines. Provides strategic consulting to clients, underwriters, executives, and senior management; presents complex findings; monitors health policy and regulatory implications; ensures actuarial standards compliance; and mentors actuarial team members.

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

Manages regulatory and client-initiated audits for a pharmacy benefit manager. Reviews audit scopes, coordinates stakeholders, gathers evidence, monitors progress, identifies risks, reviews deliverables, maintains audit records, communicates findings, and recommends remediation. The role also leads audit strategy, milestones, accountability, and process enhancement initiatives while ensuring compliance with contractual, regulatory, and accreditation requirements.

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

Lead strategic and operational oversight of pharmacy claims adjudication, benefit configuration, and network operations. Drive modernization, ensure compliance and accuracy, manage cross-functional teams, measure performance, reduce risk, and develop organizational capability to deliver client-focused outcomes.