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Contracts Analyst Sr, TennCare - Remote

Role overview

Qualifications

  • Bachelor’s degree in Business, healthcare management or related area of study, or equivalent work experience
  • 5 years of work experience in contracting or business process administration within a PBM or regulated industry
  • Must be eligible to work in the United States without the need for work visa or residency sponsorship
  • Detailed oriented and able to work with a high degree of accuracy

Responsibilities

  • Lead annual contract deliverables by partnering with internal teams
  • Process and track contract modification requests, collaborating with Finance
  • Analyze provider performance trends and report findings
  • Primary business owner for all State Comptroller audits, CMS audits, etc.

Key facts

Hard skills

Other skills

  • Negotiation
  • Detail Oriented
  • Time Management

About the company

Prime Therapeutics logo

Prime Therapeutics

Pharmacy Benefit Management (PBM)

Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 24 years. In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 28+ million members throughout the US. In addition to core PBM services, we work closely with our clients to implement the right benefit design, clinical and specialty programs, formulary and networks. A few key products: • NetResults™ • Specialty Drug Management • Best in Care™ • GuidedHealth® • Advanced Fraud, Waste and Abuse: Member and Prescriber Investigations • Prime Analytics™ • CareCentered Contracting™Controlled Substance Management Program Join us! Prime is always looking for smart, purposeful people to join our team. We’re growing fast which means there are plenty of opportunities to advance and grow in your career. At the same time, Prime supports flexibility and offers generous PTO so you can enjoy an enviable work/life balance. We’re a privately held company -big enough to make a difference and small enough for you to have an impact. Prime’s recruiting team will only contact you via phone call or through a corporate email address. Do not respond to suspicious emails or social media messages. If you have questions or are skeptical about any follow-up communications, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.

Company details

Company typeLarge
IndustryPharmacy Benefit Management (PBM)
Company size1001 - 5000

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Job description

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.

Job Posting Title

Contracts Analyst Sr, TennCare - Remote

Job Description

The Senior Contracts Analyst is responsible for the implementation and support of all activities related to developing and maintaining service provider contracts. This role interacts with all areas of the organization, obtains legal review and approval of working changes in contract documents. This position is responsible for the monitoring and development of contract compliance and for development of contract incentives.

Responsibilities

  • Lead annual contract deliverables by partnering with internal teams to ensure timely and accurate completion
  • Process and track contract modification requests, collaborating with Finance to gather data and assess potential impacts
  • Analyze provider performance trends, including cost and utilization, and report findings to support contract compliance
  • Assist with cross-functional initiatives by supporting contract coordinators and contributing to RFP and system-related projects
  • Primary business owner for all State Comptroller audits, CMS audits, internal audits, or program integrity audits
  • Other duties as assigned

Minimum Qualifications

  • Bachelor’s degree in Business, healthcare management or related area of study, or the equivalent combination of education and/or work experience; HS diploma from an accredited school or equivalent GED required
  • 5 years of work experience in contracting or business process administration within Pharmacy Benefit Management (PBM) org or other highly regulated industry

Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications

  • Detailed oriented and able to work with a high degree of accuracy
  • Demonstrated ability to complete projects independently and within established timeframes
  • Advanced experience with public sector financial/contractual analysis and negotiations including risk arrangements
  • Ability to evaluate and analyze pharmacy data and information

Preferred Qualifications

  • Pharmacy Technician (either CPT/LPT/PTCB/RPT based on State Requirements)
  • Project management experience

Every 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 $74,000.00 - $118,000.00 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).

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.

Positions will be posted for a minimum of five consecutive workdays.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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