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 TitleSr. Functional Bus Consultant (Compliance) - RemoteJob DescriptionThe Senior Functional Business Consultant The Functional Business Consultant serves as a project manager, 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 managementProvides 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 processIndependently 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 satisfactionMay 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 TestingMay provide guidance, mentoring, and work direction to others on the teamOther duties as assignedEducation & 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 required5 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 sponsorshipMust be eligible to work in the United States without the need for work visa or residency sponsorship.
Additional Qualifications
Proven client service skills with a track record for building strong client relationsImplementation experienceThorough understanding of pharmaceutical claims data and general understanding of medical claims data; highly analyticalSelf learns new processes/software to solve analytic problemsExpert interpersonal skills necessary to drive results and deliver on commitments in a collaborative fashionSkillful at meeting facilitation, conflict management, and consensus buildingCapable of handling multiple projects simultaneously and ability to work under pressure with strict timelines in a fast-paced work environmentExcellent verbal and written communication skills with prior experience giving presentationsProficiency in Microsoft Word, Excel, Project, PowerPoint, and VisioPreferred Qualifications
Rx Claims system proficiencyPrevious PBM or healthcare experienceAdvanced experience using queriesPhysical Demands
Occasional non-standard hours and travel may be requiredConstantly required to sit, use hands to handle or feel, talk and hearFrequently required to reach with hands and armsOccasionally required to stand, walk and stoop, kneel, and crouchOccasionally required to lift and/or move up to 10 poundsSpecific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focusEvery 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.