Product Owner/ Product Manager (RxClaims)

Job Description:

Looking for a Product Owner/ Product Manager/ SME with at least 8+ years of experience. This resource needs RxClaims experience and PBM (Pharmacy Benefit Management) domain experience.

From the Hiring Manager:

*An ideal candidate will have previous Prime experience as a Contractor or FTE to be able to get up to speed very quickly. Next would be someone who has worked for another PBM (Pharmacy Benefit Management) company with extensive knowledge with RxClaims and business partnerships.

Top Desired Skills:

1.) Must have prior experience with RxClaims/Pharmacy Claims
2.) Experience as a Business Consultant or Product Owner for an entire operational org.
3.) Heavy experience and understanding of operations and the business
Strategy

Prime is looking for a Sr. Functional Business Consultant to bridge the gap between the operational areas of the business and RxClaims. These are basically SME's of Claims, Benefits, Eligibility, Accums, and Prior authorization to RxClaims team. They are essential to workstream leads that work on new client implementations or system enhancement projects as it relates to RxClaims and ops.

Day to day responsibilities:
• Work directly with business and users to support and improve existing applications and processes related to assigned business system.
• With direction from a Functional Business Consultant, researches and resolves business and technical problems by identifying, evaluating, and implementing improvements to processes and applications.
• Represents assigned business system or business process as a subject matter expert in the development of business requirements, system specifications, process flows, process change and/or project management.
• Perform root cause analysis, monitor system defects for timely resolution, and complete research to determine financial impact to clients when system issues are discovered.
• Advise clients on the implementation of new business processes and systems.
• Monitor progress of projects to ensure objectives were achieved within established timelines.
• Identified areas of improvement within the organization and provided guidance on strategic initiatives.

Must have:
Bachelor's or equivalent work experience
5 years of business consultant experience
5 years of RxClaims experience
Must have knowledge of how RxClaims works in relation to operational areas vs IT areas.