Prime Therapeutics

Business Analyst

• Execute independently on small-sized projects or as part of a team of BAs on larger projects working closely with internal and external stakeholders to ensure superior customer and client experience
• Define and validate business needs with project team
• Participate in stakeholder analysis and identify subject matter experts needed for work effort
• Assess capability gaps, determine solution options and approach, and define solution scope
• Plan business analysis approach and activities
• Prepare for, conduct, and document elicitation sessions
• Manage requirements traceability to solution scope, objectives, system requirements, and testing
• Define user acceptance testing approach
• Adherence to business analysis discipline and standards in accordance with the Prime Project Lifecycle methodology

PBM Business Analyst

Product Manager

• Deliver solution products that drive value for customers
• Manage product discovery and backlog prioritization
• Collaborate with engineering teams to understand business problems
• Participate in sprint planning, reviews, and retrospectives
• Develop relationships with internal groups and customers

Senior Solution Product Owner

Administrative Assistant

• Provide administrative support to at least two members of Prime’s Senior Leadership Team (SLT) members and their corresponding departments; serve as a representative of the assigned function by effectively managing telephone calls and/or visitors and ensuring a consistent experience for all guests of the department or facility
• Manage calendar(s) as assigned and ensure adherence to scheduled appointments; specifically responsible for the intake, prioritization and scheduling of new meeting requests, as well as supporting on-time transition between meetings or appointments
• Coordinate travel on behalf of leaders or team members and ensure the appropriate lodging, car service and/or other necessary accommodations are secured; may be responsible for contracting with vendors to secure facilities and/or negotiate rates in the best interest of Prime
• Coordinate large team meetings and/or conferences that may extend beyond immediate department support; ensure facilities, technology and materials or handouts are adequately prepared and distributed
• Document, maintain and enforce policies and procedures in support of department leadership or business operations; serve as initial point of contact within the department for guidance, approval or routing to the appropriate parties on policies/ procedures that are administrative in nature
• Support department with general office duties and special projects, including but not limited to preparing presentations, meeting materials, onboarding/offboarding activities, coordinating print, administering the recognition program, ordering supplies, maintaining records and/or coordinating site events
• Capture and distribute meeting minutes at leadership or other management or committee meetings
• Works independently and within a team on special, nonrecurring or ongoing projects at the discretion of assigned SLT member; plan and coordinate presentations, disseminate information, follow up with cross-functional participants, design and deliver general correspondences, memos, charts, tables, graphs etc and proofread/edit copy for spelling, grammar and formatting inconsistencies; may be accountable for accuracy and clarity of final copy
• Other duties as assigned

Senior Administrative Assistant – IT

Analyst

• Research and resolve pharmacy contract related inquires; evaluate network participation and distribute pharmacy contract documents; coordinate timely, accurate and complete submission of contract deliverables, and the electronic and physical tracking, storage and distribution of contract documents
• Ensure all contractual obligations adhere with company policies, regulatory compliance and legal requirements; engage with Legal and Network Management leadership as needed to ensure the language provided is accurate and concise
• Establish, develop, and maintain relationships with independent pharmacy providers
• Manage legal-to-legal correspondences between Prime and independent Pharmacy Providers escalating to Prime Legal Counsel as required
• Conduct root cause analysis, including but not limited to, investigating, monitoring, resolving and reporting for pharmacy contract and pricing analysis complaints issues
• Evaluate pharmacy inquiries to include but not limited to complaints, issues and/or grievances and collaborate with internal stakeholders, such as Network Management, Client Engagement, and Benefit Operation
• Manage and edit Prime’s Provider Manual to ensure compliance and timely distribution, while contributing to process improvements that support cross-functional projects, regulatory changes, and client implementations
• Other duties as assigned

Senior Provider Relations Analyst

• Act as a champion of consulting and analytic methodology for designated line of business
• Develop analytic methodologies, models, reports and new products
• Lead complex client analytical work efforts
• Proactively investigate and build recommendations for enhancements or resolution regarding key drivers of benefit performance

Senior Drug Rebate Analyst

Consultant

• Serve as subject matter expert for assigned business systems or processes, developing requirements, specifications, process flows, and supporting change management or project delivery
• Partner with internal and external stakeholders to maintain and enhance existing applications, resolving business and technical issues to improve efficiency and user experience
• Research, evaluate, and recommend improvements to processes and system functionality, applying operational best practices and aligning with business needs
• Conduct system testing, including creation of test plans and cases, execution of User Acceptance Testing (UAT), and documentation of results to ensure quality and compliance
• Collaborate across teams to monitor and ensure compliance with applicable regulations, laws, and audit requirements, while mitigating risk through proactive process improvements

Functional Business Consultant

Risk

• Develop, implement, and maintain the ERM framework and methodology to identify, measure, monitor, and control enterprise-wide risks
• Partner with leaders across the business (Operational Risk, Compliance Risk, Information Security, etc.) to enhance the ERM function, ensuring effectiveness and efficiency
• Collaborate with stakeholders to fully develop and articulate the company’s risk management framework, clarifying roles and responsibilities of the three lines of defense
• Provide expertise in the identification and assessment of controls, development or enhancement of these controls, process improvement activities, and assessment of self-monitoring programs by management
• Define and maintain policies and SOPs for ERM framework components (risk register, issue management, incident management, etc.)
• Provide oversight and advice on compliance with the ERM Framework
• Manage the development, coordination, and administration of the ERM function, including setting, reviewing, and measuring risk management standards, and documenting standards, processes, and procedures
• Build, maintain, and enhance business relations with department and business heads for the smooth implementation of risk management activities across the organization
• Provide leadership to staff ensuring the prioritization of strategic and department level initiatives to include defining performance goals and targets. Coaching and leading a high-performance team

Manager, Enterprise Risk Management

Therapist

• Receive inbound and make outbound calls to eligible beneficiaries to schedule MTM clinician interventions in a manner that meets the specialized needs of the targeted population
• Utilize Prime’s MTM process management system to record member specific information
• Assess beneficiary information to ensure appropriate interaction is scheduled with appropriate MTM clinician (i.e., Pharmacist)
• Perform outreach calls to pharmacies to research contact information
• Address and triage queries regarding MTM related topics by transferring calls to MTM staff or other department help lines
• Document MTM eligibility and program status in the applicable software systems (i.e., MSA Toolbox, RX Claim)

Medication Therapy Management Technician

Architect

• Lead and provide thought leadership in all areas of data and information management, including master and reference data management, data modeling, data governance, data quality, data standardization, and metadata management.
• Lead and/or facilitate enterprise information and data strategy development to achieve enterprise goals and objectives
• Actively manage, communicate, and market the enterprise information architecture strategy and techniques via creation and maintenance of architecture blueprints, roadmaps, and executive presentations
• Promote and support elimination of data redundancy, fragmentation, and unnecessary movement of data through the establishment and enforcement of data system of record (SOR), source of truth (SOT), source of origin (SOO).
• Continuously improve and mature information and data architecture practice and processes
• Lead the development and application of information policies, principles, standards, patterns, and governance processes for information, data, and metadata to achieve an integrated definition of data for enterprise information, and to ensure the accuracy, validity, and reusability of metadata.
• Maintain awareness, research, drive, and lead adoption of emerging IT trends, disruptions, and practices relevant to enterprise information and data architecture
• Engage leadership to identify business and technology-enabled innovation opportunities that enable and drive business outcomes
• Lead the analysis of the business-IT environment to detect critical deficiencies, legacy, and technical debt, and recommend solutions for improvement
• Develop, maintain, and evolve the architecture and solution intent (current state, transition state, and future state) across domains
• Assist in maintaining the repository of current state, transition state, and future state information architecture deliverables
• Lead and facilitate Data Architecture community of practice meetings and represent the information and data architecture domain at the Architecture Review Board.
• Work closely with the product portfolio owners and product managers to drive a robust information and data architectural runway that can support future business requirements throughout the product and solution lifecycle
• Coach, mentor, and collaborate with technical subject matter experts and architecture peers to develop architecture that enables and drive new business capabilities and operating models

Senior Principal Enterprise Information Architect – Client and Member

Pricing Analyst

• Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of varying complexity within the pharmacy economic supply chain; utilize analytics to explore data, identify trends, and draw profitability, margin, and costs insights from multi-faceted and high dimensional financial pricing data
• Develop financial pricing models to monitor performance against pharmacy claims data and identify financial pricing opportunities to drive savings and/or meet client/pharmacy contractual obligations using analytic tools and complex financial pricing methodologies
• Apply mathematical, statistical, and economic techniques to identify key drivers of costs and profitability in the pharmacy economic supply chain as they apply to financial pricing programs, and propose and implement changes to improve accuracy of financial pricing modeling
• Act as a financial pricing subject matter expert by educating internal/external financial pricing stakeholders on financial pricing programs and interpretation of financial pricing data and reporting
• Create, recommend, implement pharmacy financial pricing targets for use by Providers Relations teams and/or pharmacy/client guarantee management processes
• Other duties as assigned

Senior Pricing Analyst

Program Manager

• Develop, execute, and lead operational plans for programs and initiatives related to assigned line of business across all market segments and for maintaining alignment and identifying interdependencies between all program level work efforts
• Collaborate with various business units, cross functional teams and key stakeholders to ensure timely, accurate and on budget implementation of programs
• Conduct analysis, designs solutions, and monitors performance against metrics, business and/or client requirements
• Manage products/programs and implement tools/enhancements to ensure new strategies are successfully developed and implemented
• Collaborate with other business units to develop business cases to support new program opportunities/enhancements and performance target metrics
• Other duties as assigned

Senior Program Manager – Trade Relations

Customer Support

• Identify high-impact customer experiences for Prime to deliver on, and define the future state using methods, tools, and deliverables that emphasize superior, end-to-end experiences
• Help teams empathize with customers by leading analysis of what people see, think, feel, and do at key points in their journeys; work with leaders to develop and track metrics to measure Customer Experience, and reveal gaps
• Help teams make ideas visible through collaborative brainstorming, sketching, and discussions
• Contribute to solution definition and requirements using persona-based journey maps, scenarios, process flows, service blueprints, and other tools/methods
• Influence senior leaders and key decision makers to drive strategic initiatives into all facets of the business (i.e. product development, clinical, operations, sales, etc.), and ultimately, to deliver customer-facing solutions
• Contribute to a multi-year Customer Experience roadmap and keep an eye on market changes, new technologies, and changing customer needs
• Listen to our customers and leverage Customer Insights studies to identify experience improvements and innovation to meet current and possible future explicit, implicit, and latent needs
• Influence design of interactions across all channels by building relationships, connecting people, and collecting insight across teams and office locations to develop holistic solutions
• Engage employees and lead culture change to align Prime employee behaviors to Customer Experience principles

Customer Experience Architect – Principal

Network Engineer

• Responsible for development and management of Prime's retail, mail, specialty and quality-based pharmacy networks
• Manage Prime's network vendor's contracting activities
• Negotiate market competitive low to medium-high complexity pharmacy agreements
• Create and manage network contracting campaigns
• Work with reporting and analytics teams to establish network reporting for pharmacy networks
• Represent Network Management department in audits and on cross-functional projects
• Ensure all contractual obligations are in adherence with company policies and legal requirements
• Establish and maintain relationships with chain, PSAOs and independent pharmacy providers

Senior Pharmacy Network Consultant

IT Support

• Cultivate a productive and supportive work environment by providing professional development opportunities, clear objectives, and resources for staff effectiveness
• Manage team performance through coaching, evaluation, and standardized performance metrics
• Facilitate strong engagement with internal and external customers, addressing business needs, resolving issues, and delivering measurable value
• Provide leadership across assigned IT ecosystem, ensuring stability, sustainability, and compliance with company standards, security, and financial policies
• Align IT strategy with organizational goals, regulatory requirements, and best practices to promote long-term quality and efficiency
• Collaborate across IT and business functions to identify solutions, improve execution, and drive innovation
• Ensure accountability by monitoring performance against budget, resources, and development priorities
• Support enterprise initiatives by implementing methodologies, services, and tools that enhance execution and productivity
• Other duties as assigned

IT Manager – AI Delivery

Underwriter

• Leading the Underwriting team responsible for providing information, analyses, and RFP support
• Providing overall direction and leadership to the underwriting teams
• Works with client engagement teams to develop, drive, and execute pricing and margin strategies
• Oversees and coordinates workflow for the underwriting team
• Works with proposal unit to ensure responses for financial responses to all RFPs are complete and accurate
• Consults with Legal and Client Engagement to ensure contractual deal terms, caveats, and pertinent information is accurate
• Assists with client contract negotiations as needed
• Engages in client and external consultant engagements
• Responsible for ensuring standard operating procedures are adhered to and that all bids are properly tracked and documented