Prime Therapeutics

Analytics Engineer

• Develops, constructs, tests and maintains data architecture, extract, load, transform (ELT) processes, logical and physical data models, data marts, meta data repositories and data warehouse designs in alignment with business requirements
• Optimizes data retrieval, develops data set processes, algorithms and identifies ways to improve data reliability, efficiency and quality
• Contributes to and maintains business glossary and other resources that foster cross-functional collaboration on analytical data resources
• Collaborates with business stakeholders to identify needs and opportunities for improved delivery, business processes and tasks that can be automated, and to understand the underlying data resources and their relationship to deliver actionable data driven insights and decision support
• Provides technical guidance to the analytics function and projects, ensuring that new initiatives enable effective analytic information management; builds and tests proof of concepts to test and demonstrate business value
• Cross-trains, supports, and works closely with team members in the following roles: Data Scientist, Systems Analyst, Report Developer

Senior Analytics Engineer

Vice President

• Define and lead the multi-year claims technology and capability strategy, including roadmap development for claims platforms
• Lead and communicate the enterprise vision for claims block, ensuring alignment to roadmap across business units
• Establish clear delivery boundaries and expectations in partnership with account management
• Drive education, communication, and adoption strategies across business units and functional teams
• Partner with Claims Operations, Configuration Operations, and Strategic Solutions teams to lead large-scale, high-impact initiatives
• Assess and manage external partner impacts and dependencies

AVP Claims Block Owner

Customer Support

• Provide exceptional support to members and providers by addressing inquiries related to eligibility, benefits, claims, and service authorizations
• Handle incoming calls and accurately document intake information into designated systems
• Engage inbound callers professionally; actively listen and probe to determine the purpose of the call and resolve administrative concerns, including claims and dissatisfaction
• Make outbound calls to solve member issues or additional information needed for a prior authorization
• Research and communicate member information while maintaining confidentiality
• Initiate care programs by accurately assembling and entering patient data
• Educate providers and members on claims submission, treatment plans, appeal processes, and reimbursement rates
• Identify and respond to crisis calls, assisting clinicians until resolution
• Document interactions thoroughly; forward necessary information to appropriate staff and refer provider-related inquiries to the correct teams

Customer Care Specialist

General

• Achieving profit, growth, service and expense objectives through financial analysis and pricing
• Evaluates the utilization and financial experience of customers and prospects
• Performs claims re-pricing analyses for complex external claims data
• Provides support to Sales, Marketing, and Client Engagement
• Consults with other departments such as Legal, IT, HPS, and Marketing

Senior Underwriter – Health Plan

General Counsel

• Provide tactical legal advice and support to internal clients including PBM, pharmacy, specialty pharmacy, and government programs
• Perform research, drafting and transactional work in support of legal matters
• Advise internal clients regarding compliance with regulatory requirements
• Develop and facilitate legal training and investigate issues as needed
• Coordinate partnership with in-house and outside legal resources

Legal Counsel

Bilingual

• Interacting with Prime members, pharmacies and doctors' offices
• Providing support and assistance with order processing and general account benefit inquiries
• Receiving incoming calls or emails from members, pharmacies, doctor's offices
• Investigating and resolving member inquiries in a timely manner or escalating to appropriate team member
• Adhering to and reinforcing Prime and departmental standard operating procedures and training guidelines specific to HIPAA
• Other duties as assigned

Bilingual Member Service Specialist

Compliance

• Manage all State and Federal policy functions
• Establish overall policy priorities and strategies
• Oversee the portfolio of all State and Federal policy materials and advocacy tools
• Provide policy education to various audiences
• Maintain partnerships with strategic leaders
• Provide effective and engaging policy education through written memos, presentations, and speaking engagements
• Coordinate and provide project management support for Board policy-related materials and meetings
• Provide information to company leaders about regulatory and legislative headwinds
• Manage policy and legislative strategy between Federal and State issues for consistency
• Lead federal regulatory comment strategy

Senior Principal, Policy and Regulatory Insights

Business Intelligence Analyst

• Develop reporting solutions following internal reporting standards and best practices by collecting, validating, interpreting, and organizing various types of data into meaningful reports and/or summaries for designated client groups
• Maintain and improve the reliability, efficiency and functionality of existing reports
• Facilitate team request intake sessions to collect reporting requirements and determine project prioritization
• Recommend quality and system improvements by analyzing the data issues, maintaining and enhancing data iteration processes, and collaborating with system owners to improve upstream processes
• Train users and team members as needed
• Other duties as assigned

Data & Reporting Analyst

Security Engineer

• The Security Engineer is responsible for supporting, implementing, and operating privileged access management (PAM) controls that protect Prime’s systems from unauthorized access, misuse, alteration, or disclosure.
• This role is dedicated to securing privileged identities, credentials, and sessions across Prime’s applications, infrastructure, and cloud environments using CyberArk.
• The engineer will perform the administration and ongoing operation of CyberArk PAM technologies, ensuring privileged access is tightly controlled, monitored, and auditable.
• This role partners closely with infrastructure, application teams, security, and business stakeholders to enable secure privileged access while maintaining operational stability, compliance, and a strong security posture.
• Produce audit evidence, compliance artifacts, and activity reports related to privileged access usage.
• Collaborate with infrastructure and application teams to design secure privileged access patterns for new and existing systems.

Security Engineer – CyberArk

Human Resources

• Maintain a positive employee relations climate by responding to employees' concerns, addressing issues proactively and advising management regarding proper follow up
• Provide guidance and coaching to supervisors and managers on routine employee-relations and performance management issues; company policies and practices; provide recommendations to and escalate issues to HR leadership as necessary; and assist with the development and delivery of appropriate feedback or disciplinary action
• Partner with Talent Acquisition on recruitment and selection process for entry level through manager level positions
• Assist supervisors and managers in writing clear and comprehensive job descriptions; work closely with compensation to evaluate positions
• Drive the annual performance appraisal process for designated customer groups, and audit appraisals to ensure employees receive clear, constructive and meaningful feedback
• Represent the HR Business Partner team by participating on HR project teams, and may lead smaller scope projects

HR Business Partner

• Provide guidance and coaching, independently, to leaders on employee-relations and performance management issues of moderate complexity, escalating when necessary; lead the development and delivery of appropriate feedback, disciplinary action, recommendation or solution surrounding an issue
• Demonstrate a strong understanding of the goals and priorities of assigned client groups, to create recommendations and set an HR agenda that supports the business and drives a positive employee experience
• Consult with HR and business leaders on organizational design and development needs, as well as, talent management initiatives, and implement plans where appropriate
• Lead or co-lead HR projects or initiatives of moderate complexity and is accountable for building collaboration across the HR organization to accomplish project milestones
• Conduct thorough and defensible investigations, drawing accurate conclusions and recommending appropriate next steps
• Partner with Talent Acquisition on recruitment and selection process for entry level employees through senior director level positions
• Other duties as assigned

Senior HR Business Partner

Actuary

• Responsible for supporting the development of actuarial concepts and providing thought leadership
• Collaborate with the Senior Principal Actuary on pricing initiatives and data analyses
• Lead complex actuarial modeling and pricing for all lines of business
• Conduct data analysis, reporting, and projections
• Provide strategic pricing advice based on market research and financial projections
• Present results and analyses to stakeholders and clients
• Mentor Actuarial team members to enhance knowledge

Principal Actuary

• Develop, deliver, and sustain a comprehensive Information Security awareness and training program for the Prime workforce
• Identify key human-related security risks and translate them into effective training
• Partner with teams to create and deliver engaging security education
• Measure the effectiveness of the security awareness program
• Plan and execute enterprise-wide tabletop exercises to test incident response and crisis management readiness
• Share technical knowledge to ensure compliance with industry regulations

Senior IT Security Trainer

• Serve as a subject matter expert on pharmacy pricing and rebate guarantees, partnering with Underwriting, Clinical, Trade, Legal, Sales, and senior leadership
• Lead the development, review, and delivery of complex pricing analyses, projections, and actuarial models
• Own and execute ad hoc pharmacy data analyses to evaluate rebate performance, market events, and actual-to-expected results
• Provide strategic pricing guidance on formulary methodology and rebate structures using market research and financial modeling
• Present analyses and recommendations to senior stakeholders and clients; respond to detailed, challenging questions with confidence
• Lead high-impact, cross-functional workstreams that require strong judgment, prioritization, and accountability
• Mentor and support Analysts and junior Actuaries through technical guidance and ongoing feedback
• Monitor health policy, regulatory, and market developments and assess implications for pricing strategy
• Ensure compliance with applicable federal regulations and actuarial standards
• Perform other duties as assigned

Lead Actuary – Pharmacy Pricing

Analyst

• Supports the development of pharmacy pricing and rebate analyses for Prime’s existing and prospective clients
• Partners with actuaries and senior leaders to deliver accurate, timely analytics
• Investigates complex pricing questions and translates data into clear insights
• Works on high‑impact analyses and provides a strong foundation for growth into advanced actuarial or pricing leadership roles
• Performs and supports pharmacy pricing analyses and rebate guarantee calculations used in client pricing, renewals, and RFPs
• Analyzes large and complex pharmacy datasets to investigate rebate performance, utilization trends, and actual‑to‑expected results
• Prepares clear summaries, exhibits, and documentation to support client discussions and senior leadership review
• Executes ad hoc analyses to support market events, client questions, and time‑sensitive requests