Treasury Claims Analyst Sr - Remote Prime Therapeutics LLCTreasury Claims Analyst Sr - RemoteRemote$81,000–$138,000 / yearPerforms all escheatment activities by working cross-functionally to develop reporting processes and controls, completing annual escheatment processes, and determining and complying with state unclaimed property laws. 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.
Pharmacy Technician - Onsite (Based in or Near Salt Lake, UT) Prime Therapeutics LLCPharmacy Technician - Onsite (Based in or Near Salt Lake, UT)Salt Lake City, UT$17.85–$25.48 / hourIf state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT). In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
Director Clinical Account Services - Remote Nevada Prime Therapeutics LLCDirector Clinical Account Services - Remote NevadaNVRemote$124,000–$211,000 / yearResponsible for working with Account Managers in identifying common customer problems that require clinical solutions, and facilitating the implementation and monitoring of clinical solutions in support of our clients'' goals to reduce expenses and improve care. Assists Account Managers with managing overall client relationship and driving the adoption of recommended clinical solutions as well as assisting Account Managers in managing the P&L of the account in order to meet targeted profitability.
Senior Analyst - Pharmacy Pricing - REMOTE Prime Therapeutics LLCSenior Analyst - Pharmacy Pricing - REMOTERemote$124,000–$211,000 / yearThis position will collaborate with the Senior Principal Actuary to provide strategic consulting support, manage the development of innovative actuarial modeling concepts, and provide pricing support for all lines of business. 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
Onsite Pharmacy Auditor - Remote (based in Southern California) Prime Therapeutics LLCOnsite Pharmacy Auditor - Remote (based in Southern California)CARemote$28.37–$45.19 / hourThe Onsite Pharmacy Auditor travels to pharmacy locations and performs pharmacy audits and is responsible for the selection and auditing of claims, educating Prime's network pharmacies and driving contract compliance, and supporting downstream claim corrections to eliminate potential waste. Evaluate potential pharmacies to include in onsite trips considering such information as claim analytic data, prior audit history, and/or referrals, and submit recommended audit plan to manager for approval; finalize onsite audit plans and schedule trips in accordance to Prime's travel and expense policy.
Legal Counsel Prime Therapeutics LLCLegal Counsel$124,000–$211,000 / year5 years of experience practicing as an attorney or related legal experience in a regulatory or compliance role, with a minimum of 3 years of experience working with managed care companies or other health care clients. Provide tactical legal advice and support to internal clients including PBM, pharmacy, specialty pharmacy, government programs, administrative support functions or other areas as assigned.
Pharmacy Claims Auditor - Remote Prime Therapeutics LLCPharmacy Claims Auditor - RemoteRemote$25.48–$40.87 / hour2 years of work experience in retail, long term care, specialty, home infusion, or mail order pharmacy or combined pharmacy and Pharmacy Benefit Management experience to include 1 year of work experience in an operations, audit or quality assurance environment. Ability to establish trust, respect and credibility and form effective working relationships with individuals at all levels of an organization; collaborate effectively cross-functionally and with clients and other key stakeholders.
Director Health Plan Underwriting - REMOTE Prime Therapeutics LLCDirector Health Plan Underwriting - REMOTERemote$124,000–$211,000 / yearIn-depth knowledge of mathematical applications used in underwriting function including the ability to calculate figures such as discounts, proportions and percentages, as well as the ability to apply basic concepts of business mathematics and algebra in underwriting problems. 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.
Senior Director Star Ratings & Quality Center of Excellence - Remote Prime Therapeutics LLCSenior Director Star Ratings & Quality Center of Excellence - RemoteRemote$143,000–$243,000 / yearLeads Center of Excellence workgroup to collaborate with key internal and external partners and vendors to create innovative offerings to drive Medicare Star Ratings that earn clients' Medicare Advantage quality bonus payments, increase affordability / reduce the total cost of care for members and clients, and enables membership growth for our clients. Lead cross-functional Star / Quality COE workgroup and steering committee with key internal partners such as clinical programs, member experience, and data/analytic to drive synergies related to quality improvement and new product / program development for Prime's Government Programs book of business.
Lead Actuary - Pharmacy Pricing - REMOTE Prime Therapeutics LLCLead Actuary - Pharmacy Pricing - REMOTERemote$124,000–$211,000 / yearEvery 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. 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.
Specialty Pharmacist - Onsite (Orlando, FL) Prime Therapeutics LLCSpecialty Pharmacist - Onsite (Orlando, FL)Orlando, FL$51.92–$88.46 / hourMinimum Qualifications: • Bachelors degree in Pharmacy • 1+ years in Pharmacy • RPH - Registered Pharmacist - Pharmacy • Must be eligible to work in the United States without the need for work visa or residency sponsorship. • Preferred Qualifications: • Pharm D • 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.
Policy and Regulatory Insights Advisor, Senior Principal - Remote Prime Therapeutics LLCPolicy and Regulatory Insights Advisor, Senior Principal - RemoteRemote$143,000–$243,000 / yearProvide coordination and project management support for Board and Board committee policy-related materials, meetings, and deliverables, including serving as staff support for the client policy advisory forum and cross-functional collaboration with other internal issue-specific task forces client advisory groups to ensure aligned stakeholder engagement and awareness of risks and opportunities in the evolving regulatory and policy environment. 10 years of work experience in government affairs, regulatory, audit or compliance roles in PBM, healthcare or other highly regulated industry, with at least 5 years of experience working directly with legislative or regulatory matters impacting PBM business.
GPRT Research Specialist Lead Prime Therapeutics LLCGPRT Research Specialist Lead$21.15–$31.73 / hourThe Lead Research Specialist position is responsible for researching and resolving complex and escalated member issues while ensuring accurate, timely, and compliant outcomes. This position serves as a subject matter expert by providing guidance on research decisions, documentation, and written communications, and by supporting quality and consistency in case handling.
Pharmacy Technician - Onsite - Must Reside in Florida (Based in or Near Orlando, FL) Prime Therapeutics LLCPharmacy Technician - Onsite - Must Reside in Florida (Based in or Near Orlando, FL)Orlando, FL$17.85–$25.48 / hourIf state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT). Communicates and coordinates internally with customer service, billing, pharmacy, and shipping departments to move patient orders through the system and meet the promised delivery date.
Senior Underwriter - Health Plan - Remote Prime Therapeutics LLCSenior Underwriter - Health Plan - RemoteRemote$81,000–$138,000 / yearIn-depth knowledge of mathematical applications used in underwriting function is required, including the ability to calculate figures such as discounts, proportions and percentages, as well as the ability to apply basic concepts of business mathematics and algebra in underwriting problems. 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.
Process Improvement Project Analyst Principal - Remote Prime Therapeutics LLCProcess Improvement Project Analyst Principal - RemoteRemote$94,000–$160,000 / yearServe as a strategic advisor to senior and executive leaders by identifying improvement opportunities, shaping future-state operating models, facilitating key decisions, and building strong partnerships across the business to drive credible outcomes. This position drives large-scale process transformation through data-driven decision making, organizational change leadership, stakeholder alignment, and sustainable benefit realization while coaching and developing others in process improvement methodologies and best practices.
Principal Actuary - Remote Prime Therapeutics LLCPrincipal Actuary - RemoteRemote$124,000–$211,000 / yearThis position will collaborate with the Senior Principal Actuary to provide strategic consulting support, manage the development of innovative actuarial modeling concepts, and provide pricing support for all lines of business. 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
Strategic Sourcing Manager - Category Management (Remote) Prime Therapeutics LLCStrategic Sourcing Manager - Category Management (Remote)Remote$66,000–$106,000 / yearParticipate in department projects and initiatives, including but not limited to, Sourcing and Finance policy management, process improvement, contract audits, contracting project management reporting, and competitive sourcing events and Request For Proposal (RFP) responses. Provide monthly, quarterly, and ad hoc reports including, but not limited to, vendor spend, contract clause library, contract pricing, vendor performance, and other ad hoc research and analysis in support of the broader sourcing team's and Prime's needs.
Oncology Product Director- REMOTE Prime Therapeutics LLCOncology Product Director- REMOTERemote$108,000–$184,000 / yearThis position will be responsible for building a deep understanding of market problems facing Prime's clients, cross-functionally leading the development and management of highly complex products and initiatives, and proving the value of those products to the market. Ability to work well across cross-functional teams including clinical, network management, operations, specialty, client engagement, market segment services and PMO teams.
Seasonal - Bilingual Member Service Specialist - Starting at 18.50 - Remote Prime Therapeutics LLCSeasonal - Bilingual Member Service Specialist - Starting at 18.50 - RemoteRemoteThe Member Services Specialist is responsible for interacting with Prime members, pharmacies and doctors' offices by providing support and assistance with order processing and general account benefit inquiries. 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
NewPharmacy Shipping Coordinator - (Based in or Near Orlando, FL) Prime Therapeutics LLCPharmacy Shipping Coordinator - (Based in or Near Orlando, FL)Orlando, FL$17.85–$25.48 / hourWe 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. 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.
NewRemote Senior Treasury Claims Analyst - Compliance Prime TherapeuticsRemote Senior Treasury Claims Analyst - ComplianceSalem, ORRemoteYou will lead discussions on liquidity, assist with escheatment, and ensure compliance with federal and state prompt pay laws while guiding junior staff and driving process improvements across treasury#J-18808-Ljbffr. Prime Therapeutics is seeking a Senior Treasury Claims Analyst (Remote) to support the claim payment process and regulatory requirements for pharmacy and member payments.
NewSenior Treasury Claims Analyst - Remote Leader Prime TherapeuticsSenior Treasury Claims Analyst - Remote LeaderDenver, CORemotePrime Therapeutics is seeking a Senior Treasury Claims Analyst to support the claim payment process, ensure regulatory compliance for pharmacy and member payments, and provide cross-functional guidance across Accounting, Finance, IT, and Claims operations. The role requires deep analytical ability, leadership in treasury processes, and collaboration with Pharmacy Networks and Government Programs.
NewSenior Treasury Claims Analyst - Remote Prime TherapeuticsSenior Treasury Claims Analyst - RemoteAustin, TXRemotePrime Therapeutics LLC is seeking a Senior Treasury Claim Analyst to support the claim payment process and regulatory requirements for pharmacy and member payments. Responsibilities include leading client/system implementations, issue triage, escheatment reporting, payment compliance analysis, and process improvements across Treasury#J-18808-Ljbffr.
NewRemote AVP, Claims Strategy & Transformation Prime TherapeuticsRemote AVP, Claims Strategy & TransformationMinneapolis, MNRemotePrime Therapeutics in Minnesota is seeking an AVP, Claims & Judi Strategy and Transformation to define and drive the enterprise vision for the claims block, aligning across units and leading large-scale initiatives to boost capabilities, technology, and efficiency. The role partners with stakeholders to develop the business value case, manage external dependencies, and shape a future-ready roadmap with leading-edge tech.#J-18808-Ljbffr.
Senior Actuarial Analyst - REMOTE Prime Therapeutics LLCSenior Actuarial Analyst - REMOTERemote$94,000–$160,000 / yearThis role will use, build, and develop innovative actuarial modeling concepts to assist strategically on trend, benefit design and pricing support for all Prime's lines of business (commercial, Medicare and Medicaid). 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
NewProduct Analyst Prime Therapeutics LLCProduct Analyst$66,000–$106,000 / yearParticipate in the solution ensuring the outcome meets the true business value by working closely with the Solution Product Owners and engineers to validate designs, facilitate demos and Product Team iterative reviews; including active involvement in the design of the systems. This role is part of a Product Team and drives collaboration with Scrum Masters, Solution Product Owners, Engineers and Quality Analysts to fulfill solution product goals, ensuring solutions align with Key Performance Indicators (KPIs) & other success measurements.
NewInfusion Referral Nurse Sr - REMOTE Prime Therapeutics LLCInfusion Referral Nurse Sr - REMOTERemote$74,000–$118,000 / yearThis role discusses financial and clinical considerations with members who are considering care at a higher cost treatment site, researches available financial programs to decrease members' out-of-pocket expense for drug services in office and coordinates lower cost site of service for drug administration if provider is referring due to convenience factors (e.g., distance, non-typical infusing provider, etc.). The Infusion Referral Nurse Sr is responsible for performing referral services to support independent physician offices with maintaining member drug infusions in office or to help offices locate a lower cost alternative treatment site (e.g., home infusion) for drug infusion services versus the hospital outpatient facility.
NewHealth Data Analyst - Remote Prime Therapeutics LLCHealth Data Analyst - RemoteRemote$66,000–$106,000 / yearIntermediate troubleshooting skills, including in-depth client data research, which may involve research and drivers of utilization; understands resources needed and steps/processes on how to complete the problem; able to understand when an issue arises how-to navigate to a resolution. 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
NewInfusion Referral Nurse Sr - REMOTE Prime Therapeutics LLCInfusion Referral Nurse Sr - REMOTERemote$74,000–$118,000 / yearThis role discusses financial and clinical considerations with members who are considering care at a higher cost treatment site, researches available financial programs to decrease members'' out-of-pocket expense for drug services in office and coordinates lower cost site of service for drug administration if provider is referring due to convenience factors (e.g., distance, non-typical infusing provider, etc.). The Infusion Referral Nurse Sr is responsible for performing referral services to support independent physician offices with maintaining member drug infusions in office or to help offices locate a lower cost alternative treatment site (e.g., home infusion) for drug infusion services versus the hospital outpatient facility.
AVP Underwriting - REMOTE Prime Therapeutics LLCAVP Underwriting - REMOTERemote$164,000–$279,000 / year12 years of work experience in financial analysis, healthcare, benefits consulting, actuarial and underwriting or financial services field to include 7 years of experience working with pricing and profitability models. • Partner with internal stakeholders in to develop aggressive pricing strategies aimed at the employer market; consult and collaborate with health plan clients to implement strategies in order to win and retain employer pharmacy business.
NewPharmacy Rebate Analyst Associate-Government Remote Prime Therapeutics LLCPharmacy Rebate Analyst Associate-Government RemoteRemote$23.08–$37.02 / hourBachelors degree in Finance or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma from an accredited school or equivalent GED required. 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.