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Prime Therapeutics Senior Benefit Plan Configuration Advisor Remote in California in Boston, Massachusetts

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

Senior Benefit Plan Configuration Advisor Remote in California

Job Description Summary

Responsible for providing subject matter expertise in interpreting complex benefit configuration plan designs for new business installations and maintenance of existing business. Serves as a liaison in defining best configuration/testing practices among multiple lines of business. Oversight of training and documentation of best practices across multiple lines of business. Assumes additional responsibilities in the absence of Manager.

Job Description

  • Develops, recommends and implements plan(s) of action to implement recommended changes to increase efficiency and performance.

  • Provides a structure to optimize the experience, skill, knowledge and capability of the team.

  • Facilitates projects that support process improvements, leveraging new system capabilities and the integration of data/other applications into existing systems.

  • Gathers and analyzes client requirements, assesses the benefit impact on current design and claims processing, presents to the stakeholder and/or other internal partners with benefit setup options, and advises on the best solution.

  • Responsible for managing complex clients / programs from a coding, testing, validation perspective as needed.

  • Leads, coordinates and consults on intermediate level projects including new customer implementations, global projects spanning multiple clients or systems, and system implementations or enhancements.

  • Provides consultation to internal/external partners to ensure intent is accurately captured and implemented for client benefit requests.

  • Collaborates internally to determine best operational approach for new business installations and benefit adjustments.

  • Oversees development of departmental policies and procedures and trains peers on the benefits teams.

  • Demonstrates an in-depth working knowledge of the benefits department`s workflow and the impact to other departments.

  • Manages project plans and performs analysis to ensure the initiative deadlines are met.

  • Oversees configuration and testing of system enhancements.

  • Other duties as assigned.

Responsibilities

  • 7+ years of experience in benefit plan configuration/analysis.

  • Strategic mindset for optimal operational effectiveness.

  • Comprehensive understanding of adjudication processes and associated applications.

  • Extended experience of adjudication processes (FirstRx preferred), analyzing benefit plan design and system application.

  • Ability to understand the system's functionality and business policies.

  • Ability to work within a team and as an individual contributor in a fast-paced, changing environment.

  • Ability to prioritize all work deliverables effectively and independently.

  • Excellent time management, organizational and written/verbal communication skills.

Work Experience

Work Experience - Required:

Benefit Plan Configuration

Work Experience - Preferred:

Education

Education - Required:

A Combination of Education and Work Experience May Be Considered., Bachelors

Education - Preferred:

Certifications

Certifications - Required:

Certifications - Preferred:

Potential pay for this position ranges from $64,285.00 - $102,855.00 based on location, experience and skills.

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 an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law.

Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's 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 people's lives.

Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. ‚Äč 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.

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