Functional Business Consultant Senior - Remote

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Hiring Remotely in Home, PA, USA
In-Office or Remote
81K-138K Annually
Insurance
The Role

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

Functional Business Consultant Senior - RemoteJob Description

The Functional Business Consultant serves as a business system or business process subject matter expert with a high level of understanding of their assigned area. This position will represent their area of expertise with regard to business system knowledge on internal and client projects, regulatory requirements, process improvement, advanced research, root cause analysis, complex issue research, documentation, advanced communications, client interaction, training, testing, ongoing system support, and developing reports and coordinating audits.

Responsibilities

  • Represents assigned business system or business process as a subject matter expert in business requirements, system specifications, process flows, process change and/or project management
  • Provides leadership to the business in the identification and adoption of operational best practices and standard operating procedures as it relates to assigned business system or business process
  • Independently researches, determines root cause and collaborates with others to resolve complex business and technical issues and customer inquiries.
  • Provides prompt and thorough resolution for client and/or member satisfaction
  • May facilitate testing for new or improved systems or processes including creation of a test plan, identifying test cases, and performing or leading User Acceptance and Joint Cycle Testing
  • May provide guidance, mentoring, and work direction to others on the team
  • Other duties as assigned

Education & Experience

  • Bachelor's degree in business administration, IT or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
  • 5 years of work experience in business analysis, project management, and/or process improvement to include:##3 years of functional experience in at least one of the specific areas for position (e.g., claims, eligibility, product, benefits, implementations or related area)
  • Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

  • Proven client service skills with a track record for building strong client relations
  • Implementation experience
  • Thorough understanding of pharmaceutical claims data and general understanding of medical claims data; highly analytical
  • Self learns new processes/software to solve analytic problems
  • Expert interpersonal skills necessary to drive results and deliver on commitments in a collaborative fashion
  • Skillful at meeting facilitation, conflict management, and consensus building
  • Capable of handling multiple projects simultaneously and ability to work under pressure with strict timelines in a fast-paced work environment
  • Excellent verbal and written communication skills with prior experience giving presentations
  • Proficiency in Microsoft Word, Excel, Project, PowerPoint, and Visio

Preferred Qualifications

  • Rx Claims system proficiency
  • Previous PBM or healthcare experience
  • Advanced experience using queries

Physical Demands

  • Occasional non-standard hours and travel may be required
  • Constantly required to sit, use hands to handle or feel, talk and hear
  • Frequently required to reach with hands and arms
  • Occasionally required to stand, walk and stoop, kneel, and crouch
  • Occasionally required to lift and/or move up to 10 pounds
  • Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

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 $81,000.00 - $138,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.

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, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local 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.

Prime Therapeutics Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Prime Therapeutics and has not been reviewed or approved by Prime Therapeutics.

  • Healthcare Strength Health coverage is described as comprehensive, with medical, dental, and vision options and plan designs that include low deductibles for some choices. Wellness screenings and related incentives add perceived value to the health offering.
  • Retirement Support Retirement benefits stand out through a 401(k) match that is characterized as generous and immediately vested. This structure improves the overall long-term value of the total rewards package.
  • Strong & Reliable Incentives Annual incentive bonuses are positioned as a meaningful component of total compensation and are often portrayed as substantial when performance goals are met. Incentive eligibility appears broadly available across roles, boosting the perceived completeness of rewards.

Prime Therapeutics Insights

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The Company
HQ: Eagan, MN
3,577 Employees
Year Founded: 1987

What We Do

Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 20 years. In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 28+ million members throughout the US. In addition to core PBM services, we work closely with our clients to implement the right benefit design, clinical and specialty programs, formulary and networks. A few key products: • NetResults™ • Specialty Drug Management • Best in Care™ • GuidedHealth® • Advanced Fraud, Waste and Abuse: Member and Prescriber Investigations • Prime Analytics™ • CareCentered Contracting™Controlled Substance Management Program Join us! Prime is always looking for smart, purposeful people to join our team. We’re growing fast which means there are plenty of opportunities to advance and grow in your career. At the same time, Prime supports flexibility and offers generous PTO so you can enjoy an enviable work/life balance. We’re a privately held company -big enough to make a difference and small enough for you to have an impact. Follow Prime on LinkedIn to learn more.

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