At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
Job Posting TitleSupv, Operations - RemoteJob DescriptionThe Supervisor Operations is responsible for ensuring their team delivers on daily production goals and support of key product offerings (Benefit/Network/FormularyDesign, e-Prescribe, Claims Processing, Integrated Product Solutions, Consumer Directed Health Plan, Medicaid and Medicare plans). This position is responsible for talent management efforts, maintenance of processes and procedures, and providing subject matter expertise for escalated issues or project support.
Responsibilities
- Monitor and manage team workload and capacity, quality metrics, cost, and efficiency to ensure performance guarantees, turnaround times and other internal and external service levels are met setting clear priorities and coaching team members when required to meet service levels and member needs
- Execute on talent management responsibilities (goal setting, performance reviews, performance feedback, discipline, development goals, business goals, training, etc.) for immediate focus area or client team
- Provide Subject Matter Expertise (SME) knowledge to internal and external stakeholders via research support, project leadership, implementation support, and internal/external audits
- Maintain and regularly update operational documentation, including Standard Operation Procedures (SOPs), Desktop Procedures (DTPs), training manuals, and related tools, to ensure accuracy, consistency, and alignment with current practices
- Resolve escalated client issues and inquiries by identifying root causes and delivering timely, effective solutions to ensure client satisfaction and retention
- Other duties as assigned
Minimum Qualifications
- Bachelor's degree in Business, Healthcare or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
- 3 years of work experience in Operations Management, Pharmacy Benefit Management, Healthcare, Insurance, or highly regulated market
Must be eligible to work in the United States without the need for work visa or residency sponsorship
Additional Qualifications
- Ability to work well within in a team and build relationships across teams
- Excellent verbal and written communication skills
- Ability to coordinate multiple projects/tasks simultaneously without compromising quality
- Strong analytical, problem solving, and decision-making skills
Preferred Qualifications
- PBM or health care experience
- Experience with RxClaims
- Supervisory/people management Experience
- Experience with E-Prescribe, Consumer Directed Health Plans, or Benefit Edit Tools
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
Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.
Potential pay for this position ranges from $59,000.00 - $94,000.00 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 (https://www.primetherapeutics.com/benefits).
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 (including pregnancy), 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.
Top Skills
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.
