Campus Pride Jobs

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Job Posting Title

Operations Supervisor - Clinical Review

Job Description

The Supervisor Operations is responsible for ensuring their team delivers on daily production goals and support of key product offerings (Benefit/Network/FormularyDesign, 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

• Execute 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 (SME) 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, healthcare or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required

• 3 years of work experience in operations management, pharmacy benefit management, healthcare, insurance, retail, or highly regulated market

• 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 supervisory experience

• Previous experience with RxClaim

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 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.

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 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. ​ 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.