Prime Careers Spotlight: July 2024

Check out our latest job openings. Together, we can help make health care better by helping clients and members navigate pharmacy benefits.

July 1, 2024

Senior Actuarial Analyst – Remote

Job description: This role leads analysis and development of efficient reporting on high-cost drug trends and the impacts of management strategies for health plan clients. The ideal candidate brings expert skills in data analysis, experience building automated models and reporting, knowledge of the health care industry and intellectual curiosity. This role communicates throughout end-to-end projects with a cross-functional team of analysts, actuaries, clinicians, IT and underwriting professionals.

Minimum qualifications
: Seven or more years analytics/informatics, seven or more years in health care and a bachelor’s degree in accounting, finance or a related area of study.

Compensation: Potential pay for this position ranges from $73,580–$117,720 a year based on experience and skills. Pay range may vary by 8% depending on applicant location.

VP Sales PBM Mid-Market Sales – Northeast

Job description: This role is responsible for attaining sustainable sales growth through current and new customers for the Pharmacy Employer market in the assigned region. Oversees requests for proposal (RFP) solicitation and response. Develops sales plans, campaigns and strategies designed to achieve sales growth targets. May be responsible for coaching, developing and managing a regional sales team.

Minimum Qualifications
: 10+ years of progressively responsible sales experience in the health care industry, two or more years management experience required, and a bachelor’s degree in communications, business administration, business management or any other related field required, or an equivalent of this requirement in directly relatable work experience is also acceptable.

Compensation: Potential pay for this position ranges from $122,624–$208,450 a year based on experience and skills. Pay range may vary by 8% depending on applicant location.

Principal of Underwriting, Large Employer Accounts – Remote

Job description: This role is responsible for achieving profit, growth, service and expense objectives through the financial analysis and pricing of Prime’s book of business. This position is responsible for developing recommendations for pricing terms; offering structure and risk analysis for highly complex and visible cases, primarily in the Health Plan markets that directly impact Prime’s goals; profit drivers and the organization’s financial value statement. This individual will serve as a subject matter expert on concerns pertaining to underwriting, performance guarantees and other financial considerations.

Minimum Qualifications
: Bachelor’s degree in mathematics, accounting or a related area of study, or equivalent combination of education and/or relevant work experience; high school diploma or GED is required. Eight years of related work experience in finance or accounting, including three years in the PBM industry.

Compensation: Potential pay for this position ranges from $94,700–$151,300 a year based on experience and skills. Pay range may vary by 8% depending on applicant location.

Talent Analytics & Reporting Analyst Sr (Payroll & Time) – Remote

Job description: This role is responsible for designing, developing and delivering impactful Human Resource (HR) reporting and analytics products and services across the enterprise. This position will play a critical role in advancing Prime’s Talent Analytics & Reporting strategy through ongoing initiatives in support of HR Compliance, Payroll & Timekeeping.

Minimum Qualifications
: Bachelor’s degree in human resources (HR), business or other related areas of study, or equivalent combination of education and/or relevant work experience; high school diploma or GED is required. Five years of work experience supporting HR technology to include HR report writing or HR analytics experience as well as one year of Workday Report Writing experience.

Compensation: Potential pay for this position ranges from $74,500–$111,700 a year based on experience and skills. Pay range may vary by 8% depending on applicant location.

Project Manager – Senior Remote

Job description: This role leads complex, strategic product integrations and assists with bringing new products to market, working in concert with senior leadership, business, IT and other project stakeholders to meet the overall project goals in terms of scope, quality, budget, issue/risk management and schedule. The role will not only drive effective planning and management of IT and business workstreams but also play a crucial role in implementing or developing new products and aligning our technology solutions with business goals. The Senior Product Implementation Manager will understand and contribute to the growth and maturity of Prime’s product life cycle while also advocating for the project management discipline and driving that rigor throughout the entire Prime organization.

Minimum Qualifications
: Bachelor’s degree in business, computer science or related area of study, or equivalent combination of education and/or relevant work experience; high school diploma or GED is required. Five years of work experience in project management across large, cross-functional projects.

Compensation: Potential pay for this position ranges from $94,700–$151,300 a year based on experience and skills. Pay range may vary by 8% depending on applicant location.

Health Guide

Job description: This role provides ongoing, community-based support for an assigned caseload of health plan enrollees to improve access to care and care coordination. Establishes a relationship with the enrollee, the care coordination team and providers. Conducts new enrollee outreach and orientation, arranges appointments and transportation as needed. Assists the enrollee in learning to navigate the health care delivery system, community resources and  transportation, and to effectively use health plan benefits.

Minimum Qualifications
: Experience with individuals who have severe mental illness or chronic medical conditions. Experience in community service, health care or social services and/or community-based or home health care experience required. Managed care experience preferred. Experience documenting in a clinical record or information system. Knowledge of local community resources and familiarity with health care coding (ICD, DSM).

Compensation: Potential pay for this position ranges from $18.87–$28.30 an hour based on experience and skills. Pay range may vary by 8% depending on applicant location.

Principal Software Engineer .NET C# – Remote

Job description: This position serves as an expert technical and industry resource to management, clients and development staff in new uses of information technology in all phases of major system and subsystem development. Provides consultation on internal and industry IT technical and business domain process capabilities including leadership in the identification and recommendation of new IT opportunities and business operations as it relates to application development. Formulates, contributes to and directs task identification, work effort estimates, and work schedules for research, prototype and proof-of-concept IT activities. Directs and participates in all aspects of development tasks including data management, application architecture and business architecture. Provides guidance to staff on complex assignments and mentors on new technologies.

Minimum Qualifications
: Seven or more years of related experience including a minimum of three or more years of designing, building and maintaining high-quality, secure software in IT. Profficent working with .NET, C#, SQL Server and VB.NET.

Compensation: Potential pay for this position ranges from $97,760–$166,180 a year based on experience and skills. Pay range may vary by 8% depending on applicant location.

Product Director – Remote

Job description: This role is accountable for developing and executing initiatives on Prime’s product roadmap across the Commercial and Government Programs strategic business units. This position will be responsible for building a deep understanding of market problems facing Prime’s clients, cross-functionally leading the development and management of highly complex products and initiatives, and proving the value of those products to the market. In addition, this position will work collaboratively with leaders and product owners in other departments to develop product standards, moving from ideation to execution.

Minimum Qualifications
: Bachelor’s degree in marketing, business or a related area of study, or equivalent combination of education and/or relevant work experience; high school diploma or GED is required. Eight years of related business experience with at least five years in product development.

Compensation: Potential pay for this position ranges from $109,000–$174,000 a year based on experience and skills. Pay range may vary by 8% depending on applicant location.

Principal Recruiter

Job description: This role is responsible for professional, senior level, and executive recruiting within and outside of their assigned business with an increased emphasis in leading executive recruitment strategies across the organization.  This position serves as a strategic and consultative partner to the business interfacing directly with business and functional leaders.  This position is responsible for executing an effective job posting, sourcing strategy, and recruiting process to attract, source, assess and select high-quality candidates. This role will support the development and enhancement of recruitment processes and provide day-to-day guidance and training to others on the Talent Acquisition team.

Minimum Qualifications
: Bachelor’s degree in human resources (HR) or related field or equivalent combination of education and/or work experience. Eight years of work experience in recruiting/talent acquisition or HR, with a minimum of two years of experience in senior leadership or executive recruiting.

Compensation: Potential pay for this position ranges from $94,700–$151,300 a year based on experience and skills. Pay range may vary by 8% depending on applicant location.

Lead Rebate Billing Specialist

Job description: This role oversees daily operations as outlined by management. Answer questions and resolve problems related to billing operations as the billing expert. Communicate and coordinate timely communication of identified problems to assure proper follow up is completed to expedite claims and ensure proper payment.

Minimum Qualifications
: Intermediate-level Excel skills, a working knowledge of Ten-Key by touch, ability to type average 40+ words per minute, must be detail oriented and possesses experience deciphering contract language.

Compensation: Potential pay for this position ranges from $20.76–$31.14 per hour based on experience and skills. Pay range may vary by 8% depending on applicant location.

Internal Candidate Disclaimer

If you are a current Prime employee seeking a new position, please apply through the internal portal on your Workday profile. Please do not apply via the links included throughout this article.

Help reimagine pharmacy management

Join us and help reimagine pharmacy benefit management to provide the same care you would want for your loved ones. Check out our Careers page to see additional job listings, benefits and more.

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