Benefit Plan Configuration Advisor Assoc - Remote

Our work matters. We help people get the medicine they need to feel better and live well.  We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Benefit Plan Configuration Advisor Assoc - RemoteJob Description

This position specializes in the analysis and application of intermediate level benefit plan design requirements. A successful Analyst will ensure a high level of quality and accuracy through benefit configuration, test execution and validation efforts while serving as a subject matter expert on benefits and claim adjudication system coding setup.

Responsibilities

• Analyzes new business requirements for benefit design changes to establish the appropriate solution.
• Complies with standards set forth regarding benefit design and configuration including but not limited to Health Insurance
• Portability and Accountability Act of 1996 (HIPAA) and National Council for Prescription Drug Programs (NCPDP).
• Maintains technical documentation based on standard operating procedures.
• Partners with various teams to analyze customer specific requirements and configuration and translate those into technical design specification and data flow from which programs are developed and coded.
• Actively participates in and contributes to daily communications, team meetings and project/issue resolution.
• Responsible for accurate management of plan benefits coding changes, test execution and validation efforts of plan benefit design requests.
• Maintains customer documentation that validates configuration.
• Efficiently and effectively distributes tasks, using clear and concise instructions and expectations.
• Completes deliverables independently and within an agile team setting.
• Other duties as assigned.

Education & Experience

• Bachelor's degree or equivalent combination of education and/or work experience; HS diploma or GED is required

• Less than 2 years experience in Benefit Plan Configuration

• Must be eligible to work in the United States without the need for work visa or residency sponsorship.

Additional Qualifications

• This role requires strong attention to detail, critical thinking and analytical skills
• Strong working knowledge of Microsoft Office suite, specifically Word and Excel, including running queries and macros.
• Ability to work within a team and as an individual contributor in a fast-paced, changing environment.
• Ability to identify and resolve process and/or systems issues.
• Strong sense of urgency leading to the timely completion of all projects, training and assignments.

Preferred Qualifications

• Experience with adjudication processes (FirstRx preferred), analyzing benefit plan design and system application.
• Previous PBM or Pharmacy experience
• Experience supporting Medi-Cal

Physical Demands

• Must be able to remain in a stationary position 50% of the time. Must be able to “move or traverse”
• Must be able to constantly operate a computer and/or other office productivity equipment.
• Must be able to hear and constantly communicate information and ideas. Must be able to exchange accurate information.

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

Potential pay for this position ranges from $23.08 - $37.02 based on experience and skills.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law. 

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.