Provider Relations Manager

Provider Relations Manager - RemoteAt Prime Therapeutics (Prime), we are reimagining pharmacy solutions to provide the care we would want for our loved ones. That purpose energizes our team and creates limitless opportunities to make a difference. We know that people make all the difference. If you're ready for a purpose-driven career and are passionate about simplifying health care, let's build the future of pharmacy together.The Manager of Provider Relations plays a critical leadership role in developing, managing, and maintaining strong internal and external relationships. The role is responsible for overseeing pharmacy outreach, independent pharmacy contracting, compliance, and issue resolution with pharmacies to ensure network integrity, service quality, and cost-effectiveness. The role is also responsible for leading and managing a Provider Relations team to ensure effective performance management of employees, departmental interaction, and process improvements.Responsibilities:Manage and mentor a team to achieve team and company goals, monitor performance and provide coaching and development opportunitiesManage team through independent pharmacy contract processes for retail networks; serve as the primary point of contact for key pharmacy providers, including pharmacy outreach and strategic partners to ensure quality outcomes; includes oversight where pharmacy termination from pharmacy networks may occurOversee and approve new key processes the team develops as part of continuous improvement and develop strategies to achieve world class status in operational effectiveness and pharmacy and client experience while ensuring compliance and adherence to all regulatory guidelinesServe as liaison between Prime and pharmacies by supporting legal correspondence, addressing escalated provider concerns and disputes, and strengthening the interface between contact center operations and provider relations through effective pharmacy communicationsDevelop and maintain relationships with internal and external stakeholders regarding the management and development of Network Management strategies; actively oversee and support Peak Season activities, including pharmacy outreach and pharmacy communicationsMinimum Qualifications:Bachelor's degree in healthcare, business or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required6 years of work experience in customer service or contracting experience within healthcare, PBM or highly regulated industry2 years of leadership/people management experience Must be eligible to work in the United States without the need for work visa or residency sponsorshipAdditional Qualifications:Ability to learn complex IT systems, both internal and web based and be able to train others to use systems and maintain best practices and quick reference guidesAbove average knowledge of Microsoft Office Suite of products, including Excel and PowerPointDemonstrated business written and oral communication skillsDemonstrated ability to establish and rapport and build relationships at all levels within an organizationStrong attention to detail, follow through and root cause analysis of issuesExcellent organizational, time management, problem solving and analytical skillsPreferred Qualifications:Previous experience in pharmacy network management, legal or compliancePrevious project management skillsPrevious experience with RxClaimPrevious call center experienceCertified Pharmacy Technician (CPhT)Previous work experience in the PBM or Healthcare IndustryPrevious experience leading a team in a call center environmentEvery employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures. Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job. Potential pay for this position ranges from $81,000.00 - $138,000.00 based on experience and skills.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, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local 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.