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
Senior Enrollment Specialist
Job Description Summary
This position is responsible for processing, data entry and file maintenance of enrollment, assessment and dis-enrollment documentation for strategic business unit (SBU) operations.
Job Description
- Effectively supports Magellan's SBU program operations ensuring that data is entered accurately and timely as required by contract service level agreements.
- Communicates with appropriate contacts on eligibility issues and questions.
- Answers incoming calls on eligibility, program benefits, plan limitations and point of sale edits from providers.
- Proficient use of enrollment and claims point of sale for research and problem resolution.
- Assists in data collection and reporting.
- Completes bi-weekly checkwrite production for provider payment in the accounts payable system, reporting all operational issues and assisting with system issues.
- Assists with quality monitoring and provides constructive feedback.
- Reviews production reports, identifies issues and recommends resolutions; continually seeks to improve processes and increase efficiencies.
- Assists in data collection and reporting.
- Other special projects as required by management.
Responsibilities
- Experience in health care, managed care or pharmacy management preferred.
- Must be a team player, flexible, organized and able to manage multiple tasks.
- Possess strong verbal and written communication skills.
- Possess interpersonal skills such as initiative, resourcefulness and integrity.
- Ability to interact with internal and external clients with confidence, assertiveness and a pleasant demeanor.
- Strong computer skills and working knowledge of Microsoft Office Suite.
- Ability and willingness to learn other proprietary computer systems quickly and efficiently.
Work Experience
Work Experience - Required:
Customer Service
Work Experience - Preferred:
Education
Education - Required:
Education - Preferred:
Bachelors
Certifications
Certifications - Required:
Certifications - Preferred:
Potential pay for this position ranges from $18.87 - $28.30 based on experience and skills. Pay range may vary by 8% depending on applicant location.
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, 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.
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.