Teams at Prime Therapeutics

Lead regulatory assessments, external audits, and accreditation activities for Commercial, Medicare, Medicaid, and Marketplace programs. Act as primary contact for clients, auditors, and accreditation reviewers; manage gap reporting, SOP maintenance, change management, and responses to compliance inquiries; participate in regulatory committees and CMS calls.

Provide project coordination and administrative support for PBM functional areas (formulary, utilization management, P&T coordination). Track documentation, generate reports, support client meetings and communications, and assist with program implementation and regulatory adherence.

Manage development and contracting of Prime's retail, mail, specialty and quality-based pharmacy networks. Negotiate pharmacy agreements, run contracting campaigns, analyze network adequacy and performance, support audits and cross-functional projects, ensure regulatory and contractual compliance, and maintain provider relationships with chains, PSAOs and independents.