Supervisor Operations, Claims Research – Remote

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 Title

Supervisor Operations, Claims Research – Remote

Job Description

The Supervisor Operations is responsible for ensuring their team delivers on daily production goals and support of key product offerings (Benefit Design, e-Prescribe, Claims Processing, Integrated Product Solutions, Consumer Directed Health Plan). This position is responsible for talent management efforts, maintenance of processes and procedures, and providing subject matter expertise for escalated issues or project support.

Responsibilities

Monitor and manage team workload and capacity, quality metrics, cost, and efficiency to ensure performance guarantees, turnaround times and other internal and external service levels are met

Executes on talent management responsibilities (goal setting, performance reviews, performance feedback, discipline, development goals, business goals, training, etc.) for immediate focus area or client team

Provide Subject Matter Expertise knowledge to internal and external stakeholders via research support, project leadership, implementation support, and internal/external audits

Responsible for maintaining and updating processes and procedures (i.e. Standard Operating Procedures (SOPs), Desk Top Procedures (DTPs), training manuals, and other operational procedures and tools

Responsible for addressing escalated client issues/inquiries and delivering solutions

Other duties as assigned

Minimum Qualifications

Bachelor’s degree in business or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required

3 years’ experience managing people or projects consisting of long duration, high budget, and/or multiple work streams

Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

Ability to work well within in a team and build relationships across teams

Excellent verbal and written communication skills

Ability to coordinate multiple projects/tasks simultaneously without compromising quality

Strong analytical, problem solving, and decision making skills

Preferred Qualifications

Previous experience with E-Prescribe, Consumer Directed Health Plans, or Benefit Edit Tools

Previous experience in Pharmacy Benefit Management or related healthcare experience

Previous experience with RxClaim

Pharmacy Technician Certification preferred

Previous experience with Medicare or Medicaid

Minimum Physical Job Requirements

Must be able to work outside of Prime core business hours (9 AM – 4 PM), to work overtime, weekends, and holidays, as needed

Constantly required to sit, use hands to handle or feel, talk and hear

Frequently required to reach with hands and arms

Occasionally required to stand, walk and stoop, kneel, and crouch

Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds

Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Reporting Structure

Reports to Manager or Director in Operations

Potential pay for this position ranges from $64,700.00 – $97,100.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/careers/benefits/) 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, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by 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.

Prime Therapeutics fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in todays health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.

If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in peoples lives.

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, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by 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.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.