Prime Therapeutics

Physician Clinical Reviewer -Psychiatry- REMOTE

Prime Therapeutics · Part Time · 14 hours ago

Prime Therapeutics

🌎 United States 💵 $90.87 - $154.33 per hour ⭐ 2-5 yrs exp 💼 Healthcare

The Physician Clinical Reviewer provides timely medical review of service requests that do not meet initial medical necessity guidelines. They also communicate with providers to discuss determinations and provide clinical rationale for appeals.

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Data & Reporting Analyst (Remote)

Prime Therapeutics · Full Time · 16 hours ago

Prime Therapeutics

🌎 United States 💵 $59000 - $94000 per year ⭐ 2-5 yrs exp 💼 Others

The Data & Reporting Analyst supports business decision-making by developing, maintaining, and improving reporting solutions and business intelligence services. This role involves facilitating request intake sessions, interpreting data, and collaborating with system owners to enhance data processes.

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AVP Claims & Configuration - REMOTE

Prime Therapeutics · Full Time · a day ago

Prime Therapeutics

🌎 United States 💵 $164K - $279K per year ⭐ 10+ yrs exp 💼 Legal

The AVP of Claims & Configuration leads the strategic leadership and operational performance of pharmacy benefit claims adjudication and benefit configuration. This role drives technology modernization and ensures accurate, compliant administration of pharmacy benefit programs while managing cross-functional teams.

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Provider Relations Analyst Sr (Contract Negotiation) - Remote

Prime Therapeutics · Full Time · 2 days ago

Prime Therapeutics

🌎 United States 💵 $66000 - $106K per year ⭐ 5-10 yrs exp 💼 Others

The Provider Relations Analyst Sr manages independent pharmacy network contracting activities and ensures compliance with company policies and legal requirements. They also resolve escalated pharmacy inquiries, maintain the Provider Manual, and conduct root cause analysis for contract and pricing complaints.

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Regulatory Analyst Sr (Remote)

Prime Therapeutics · Full Time · 3 days ago

Prime Therapeutics

🌎 United States 💵 $81000 - $138K per year ⭐ 5-10 yrs exp 💼 Legal

The Senior Regulatory Analyst leads departmental regulatory reviews, external audits, and accreditation processes across various healthcare programs. They serve as the primary point of contact for business partners regarding regulatory activity, quality efforts, and policy development.

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Associate Rebate Analyst - Remote

Prime Therapeutics · Full Time · 3 days ago

Prime Therapeutics

🌎 United States 💵 $23.08 - $37.02 per hour ⭐ 0-2 yrs exp 💼 Others

The Associate Rebate Analyst supports client operations by managing payment postings, dunning letters, and service agreements. They also assist with invoicing processes and provide reporting support for various rebate and managed care programs.

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Recovery & Resolution Analyst - Remote

Prime Therapeutics · Full Time · 3 days ago

Prime Therapeutics

🌎 United States 💵 $53000 - $85000 per year ⭐ 2-5 yrs exp 💼 Others

The Recovery & Resolution Analyst manages the recovery of inappropriate pharmacy payments through claim adjustments, payment withholding, and collection agency coordination. They also prepare detailed reports on recovery processes and identify opportunities for operational improvements.

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Business Solution Analyst Sr

Prime Therapeutics · Full Time · 3 days ago

Prime Therapeutics

🌎 United States 💵 $81000 - $138K per year ⭐ 5-10 yrs exp 💼 Others

The Senior Business Solution Analyst acts as a liaison between business operations, technology groups, and stakeholders to define and facilitate business requirements for strategic initiatives. They are responsible for assessing capability gaps, managing requirements traceability, and ensuring adherence to project lifecycle methodologies.

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Senior Actuarial Analyst - REMOTE

Prime Therapeutics · Full Time · 5 days ago

Prime Therapeutics

🌎 United States 💵 $94000 - $160K per year ⭐ 5-10 yrs exp 💼 Finance

The Senior Actuarial Analyst is responsible for building and maintaining complex financial and actuarial models to support pricing and trend analysis. This role involves collaborating with cross-functional teams and presenting data-driven insights to senior leadership and clients.

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Product Analyst

Prime Therapeutics · Full Time · 7 days ago

Prime Therapeutics

🌎 United States 💵 $66000 - $106K per year ⭐ 2-5 yrs exp 💼 Product

The Product Analyst delivers complex solution products by collaborating with cross-functional teams to refine user stories and ensure alignment with business KPIs. They are responsible for validating designs, facilitating system demos, and managing data models to support development and testing.

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Infusion Referral Nurse Sr – REMOTE

Prime Therapeutics · Full Time · 8 days ago

Prime Therapeutics

🌎 United States 💵 $74000 - $118K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Infusion Referral Nurse Sr coordinates site-of-service solutions for patients to reduce healthcare costs while ensuring clinical quality. They educate members and providers on financial impacts and manage prior authorizations within a remote clinical environment.

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Oncology Infusion Referral Nurse Sr – REMOTE

Prime Therapeutics · Full Time · 8 days ago

Prime Therapeutics

🌎 United States 💵 $74000 - $118K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Oncology Infusion Referral Nurse Sr coordinates site-of-service solutions to transition patients to lower-cost infusion alternatives while educating them on financial and clinical considerations. They are responsible for maintaining accurate case documentation, validating prior authorizations, and supporting members with copay assistance programs.

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Health Data Analyst - Remote

Prime Therapeutics · Full Time · 9 days ago

Prime Therapeutics

🌎 United States 💵 $66000 - $106K per year ⭐ 2-5 yrs exp 💼 Software Development

The Health Data Analyst provides information, analyses, and consultation to stakeholders regarding pharmacy benefit performance. They are responsible for creating analytical models, developing new reports, and investigating key drivers of benefit performance.

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Senior Director Star Ratings & Quality Center of Excellence - Remote

Prime Therapeutics · Full Time · 13 days ago

Prime Therapeutics

🌎 United States 💵 $143K - $243K per year ⭐ 10+ yrs exp 💼 Others

Lead the strategy and execution of programs designed to improve Medicare and Managed Medicaid quality measurements and Star Ratings. Manage a team of quality managers and analysts to develop tools and resources that drive client quality bonus payments and membership growth.

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Strategic Sourcing Manager - Category Management (Remote)

Prime Therapeutics · Full Time · 16 days ago

Prime Therapeutics

🌎 United States 💵 $66000 - $106K per year ⭐ 2-5 yrs exp 💼 Others

The Strategic Sourcing Manager executes sourcing strategies for lower-risk and lower-spend vendor categories. This includes managing RFx processes, negotiating contracts, and providing spend analysis reports to support the broader sourcing team.

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Process Improvement Project Analyst Principal - Remote

Prime Therapeutics · Full Time · 16 days ago

Prime Therapeutics

🌎 United States 💵 $94000 - $160K per year ⭐ 5-10 yrs exp 💼 Teaching

Lead enterprise-wide transformation initiatives using Lean Six Sigma to deliver financial and operational outcomes. Serve as a strategic advisor to executive leadership while coaching and developing other process improvement practitioners.

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Lead Actuary - REMOTE

Prime Therapeutics · Full Time · 17 days ago

Prime Therapeutics

🌎 United States 💵 $124K - $211K per year ⭐ 10+ yrs exp 💼 Finance

The Lead Actuary develops actuarial concepts and provides strategic pricing support and thought leadership for clients and owners. This role involves leading complex, high-visibility projects and mentoring team members to enhance actuarial knowledge.

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Principal Actuary - Remote

Prime Therapeutics · Full Time · 17 days ago

Prime Therapeutics

🌎 United States 💵 $124K - $211K per year ⭐ 10+ yrs exp 💼 Finance

The Principal Actuary provides strategic consulting and thought leadership for pricing initiatives and actuarial modeling. They lead complex, high-visibility projects and mentor team members to enhance actuarial knowledge across the organization.

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Oncology Product Director- REMOTE

Prime Therapeutics · Full Time · 22 days ago

Prime Therapeutics

🌎 United States 💵 $108K - $184K per year ⭐ 5-10 yrs exp 💼 Product

The Product Director is responsible for developing and executing the product roadmap for Commercial and Government Programs, specifically focusing on oncology products. This includes leading product ideation, conducting market assessments, and managing the end-to-end lifecycle from design to market launch.

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