Healthcare Operations Specialist

4 weeks ago


Albuquerque, New Mexico, United States Prime Therapeutics Full time
About Our Company
At Prime Therapeutics, we believe that everyone deserves access to the medicine they need to feel better and live well. As a leading pharmacy benefit manager (PBM), we strive to deliver innovative solutions that improve patient outcomes and reduce healthcare costs.

We're seeking a skilled Healthcare Operations Specialist to join our team. In this role, you'll support our SBU program operations by processing, data entry, and file maintenance of enrollment, assessment, and dis-enrollment documentation. This is a remote work-from-home position that requires residing in the state of Connecticut.

As a key member of our team, you'll be responsible for entering data accurately and timely as required by contract service level agreements. You'll also communicate effectively with internal and external clients, handle incoming calls on eligibility, program benefits, plan limitations, and point-of-sale edits from providers and discharge planners. Additionally, you'll assist with data collection and reporting, complete bi-weekly checkwrite production for provider payment, and provide constructive feedback.

The ideal candidate will have experience in healthcare, managed care, or pharmacy management, preferably with enrollment processing/data entry experience. They must be a team player, flexible, organized, and able to manage multiple tasks. Strong verbal and written communication skills are essential, along with attention to detail and the ability to work efficiently to meet deadlines and timelines.

This position offers a competitive salary ranging from $16.00 to $23.39 based on experience and skills. The pay range may vary by 8% depending on applicant location. We offer a comprehensive benefits package, which includes health insurance, retirement plans, and paid time off. Visit our Benefits Page for more details.

Prime Therapeutics LLC is an equal opportunity and affirmative action employer. We welcome diverse candidates to apply and encourage qualified applicants with arrest and conviction records to do so. We're proud to be a tobacco-free workplace.

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