Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Director Pharmacy Network Compliance - Remote
The Director Pharmacy Network Compliance will lead the creation of a strategic roadmap for the pharmacy network compliance function and work with key internal stakeholders across the enterprise to coordinate operational support. This position will be accountable for the intake, implementation and management of projects, system development and enhancements and/or training and turnover to the applicable operational area while driving aggressive change programs and effective partnerships across the business.
Responsibilities
Develop and lead the implementation of Pharmacy Network Compliance initiatives in alignment with Prime's goals and strategic imperatives; may develop key performance indicators and metrics to inform and support business decisions
Drive operational and process improvements within Network Management and in partnership with key internal business leaders to ensure projects are completed and turned over to operational teams to facilitate ongoing management and benefit realization
Develop and manage department budgets, staff goals and objectives, project plans and resource allocations; responsible for cost management, including staff time tracking, productivity standards and expense management
Ensure client and regulatory requirements are incorporated into shared operating procedures; develop standardized processes that use work standardization and on-line tools so that efficiency and scalability are achieved; define and achieve operational and service metrics (e. g. , quality, time and cost metrics)
Direct and oversee processes, procedures and related reporting to ensure regulatory requirements and applicable accreditation/certification standards are met; ensure that action plans are in place to prevent repeat internal or external audit findings as applicable
Provide leadership and/or support for business analysis, system enhancements, business deliverables, and project management services in support of designated operational areas; may also drive the development and maintenance of standard operating procedures and desktop procedures
Manage department budget, staffing, performance and development, and consistently demonstrate Prime's leadership expectations during interactions with direct reports, cross functional and external stakeholders
Other duties as assigned
Education & Experience
Bachelor's degree in Business, IT, Project Management, or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
8 years of work experience in Healthcare, PBM, Operations, Regulatory Compliance Business Analysis and/or Project Management
5 years of leadership/people management experience
Must be eligible to work in the United States without need for work visa or residency sponsorship
Additional Qualifications
Strong leadership skills with the ability to effectively select, develop, engage, coach, retain, leverage, and mobilize top talent
Effective written and verbal communication skills
Ability to think critically and anticipate the broad impact of decisions
Ability to establish rapport and build relationships at all levels within an organization
Superior negotiation and influencing skills
Advanced ability with Microsoft Office applications
Preferred Qualifications
MBA
Previous experience developing and overseeing Business Analysis, Project Management, System Development, Training and/or Quality Programs
Physical Demands
Ability to travel up to 10% of the time
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
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.
Potential pay for this position ranges from $108,000. 00 - $184,000. 00 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (/ primetherapeutics. com/benefits) and click on the "Benefits at a glance" button for more detail.
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, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by 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.
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 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, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.
We welco.
US - NM - NM - Santa Fe
January 24, 2025
Focus Staff is seeking a travel Physical Therapist for a travel job in Santa Fe, New Mexico. & Requirements • Specialty: Physical Therapist • Discipline: Therapy • Start Date: 02/10/2025 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment Type: Travel Focus Staff is seeking...
US - NM - NM - Portales
January 24, 2025
Focus Staff is seeking a travel nurse RN Med Surg for a travel nursing job in Portales, New Mexico. & Requirements • Specialty: Med Surg • Discipline: RN • Start Date: 02/17/2025 • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, days • Employment Type: Travel Focus Staff is seeking a Med...
US - NM - NM - Santa Fe
January 23, 2025
Magnet Medical is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Santa Fe, New Mexico. & Requirements • Specialty: ED - Emergency Department • Discipline: RN • Start Date: ASAP • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, nights • Employment Type:...
US - NM - NM - Alamogordo
January 24, 2025
Focus Staff is seeking a travel Radiology Technician for a travel job in Alamogordo, New Mexico. & Requirements • Specialty: Radiology Technician • Discipline: Allied Health Professional • Start Date: 02/10/2025 • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, days • Employment Type:...
US - NM - NM - Portales
January 23, 2025
Wellspring Nurse Source is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Portales, New Mexico. & Requirements • Specialty: ED - Emergency Department • Discipline: RN • Start Date: 02/03/2025 • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, nights •...
US - NM - NM - Silver City
January 25, 2025
Supplemental Health Care is seeking a LPN / LVN for a travel job in Silver City, New Mexico. & Requirements • Specialty: LPN / LVN • Discipline: LPN / LVN • Start Date: ASAP • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days, nights • Employment Type: Travel Supplemental Health Care is...
US - NM - NM - Clovis
January 8, 2025
Overview: Find Your Passion and Purpose as a Home Health Physical Therapist Bonus:$20,000 Rate or Salary Range: $98,000 to $115,000 Schedule: M-F 8 to 5 Territory: Clovis, NM and surrounding Reimagine Your Career in Home Health As a medical professional, you know that what you do impacts you as much...
US - NM - NM - Carlsbad
January 23, 2025
MedPro Healthcare Staffing is seeking a travel nurse RN ICU - Intensive Care Unit for a travel nursing job in Carlsbad, New Mexico. & Requirements • Specialty: ICU - Intensive Care Unit • Discipline: RN • Start Date: 02/06/2025 • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, nights •...
US - NM - NM - Clovis
January 8, 2025
Overview: Find Your Passion and Purpose as a Home Health Physical Therapist Bonus:$20,000 Rate or Salary Range: $98,000 to $115,000 Schedule: M-F 8 to 5 Territory: Clovis, NM and surrounding Reimagine Your Career in Home Health As a medical professional, you know that what you do impacts you as much...
US - NM - NM - Portales
January 19, 2025
Travel Nurses, Inc. is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Portales, New Mexico. & Requirements • Specialty: • ED - Emergency Department • Discipline: • RN • Duration: • 13 weeks • 36 hours per week • Shift: • 12 hours, nights • Employment Type: • Travel...
US - NM - NM - Santa Fe
January 23, 2025
Wellspring Nurse Source is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Santa Fe, New Mexico. & Requirements • Specialty: ED - Emergency Department • Discipline: RN • Start Date: ASAP • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, nights • Employment...
US - NM - NM - Alamogordo
January 23, 2025
Ardor Health Solutions is seeking a travel Physical Therapist for a travel job in Alamogordo, New Mexico. & Requirements • Specialty: Physical Therapist • Discipline: Therapy • Start Date: 02/10/2025 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment Type: Travel •...
US - NM - NM - Las Cruces
January 20, 2025
Ardor Health Solutions is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Las Cruces, New Mexico. & Requirements • Specialty: Med Surg / Telemetry • Discipline: RN • Start Date: 02/03/2025 • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, days • Employment Type:...
US - NM - NM - Artesia
January 24, 2025
MedPro Healthcare Staffing is seeking a travel nurse RN Med Surg for a travel nursing job in Artesia, New Mexico. & Requirements • Specialty: Med Surg • Discipline: RN • Start Date: 02/07/2025 • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, nights • Employment Type: Travel MedPro...
US - NM - NM - Clovis
January 8, 2025
Overview: Find Your Passion and Purpose as a Home Health Physical Therapist Bonus:$20,000 Rate or Salary Range: $98,000 to $115,000 Schedule: M-F 8 to 5 Territory: Clovis, NM and surrounding Reimagine Your Career in Home Health As a medical professional, you know that what you do impacts you as much...
US - NM - NM - Portales
January 23, 2025
Magnet Medical is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Portales, New Mexico. & Requirements • Specialty: ED - Emergency Department • Discipline: RN • Start Date: 02/03/2025 • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, nights • Employment...
US - NM - NM - Portales
January 24, 2025
Focus Staff is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Portales, New Mexico. & Requirements • Specialty: ED - Emergency Department • Discipline: RN • Start Date: 02/03/2025 • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, nights • Employment Type:...
US - NM - NM - Albuquerque
January 24, 2025
Travel Nurses, Inc. is seeking a travel nurse RN Case Management for a travel nursing job in Albuquerque, New Mexico. & Requirements • Specialty: • Case Management • Discipline: • RN • Duration: • 13 weeks • 40 hours per week • Shift: • 8 hours • Employment Type: • Travel We are looking for Case...
US - NM - NM - Santa Fe
January 24, 2025
Supplemental Health Care is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Santa Fe, New Mexico. & Requirements • Specialty: PCU - Progressive Care Unit • Discipline: RN • Start Date: ASAP • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days, nights •...
US - NM - NM - Clovis
January 23, 2025
Supplemental Health Care is seeking a travel nurse RN Skilled Nursing for a travel nursing job in Clovis, New Mexico. & Requirements • Specialty: Skilled Nursing • Discipline: RN • Start Date: ASAP • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, days • Employment Type: Travel As one of...
US - NM - NM - Santa Fe
January 21, 2025
Ardor Health Solutions is seeking a travel Radiology Technologist for a travel job in Santa Fe, New Mexico. & Requirements • Specialty: Radiology Technologist • Discipline: Allied Health Professional • Start Date: 02/10/2025 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days •...
US - NM - NM - Santa Fe
January 23, 2025
Ardor Health Solutions is seeking a travel Physical Therapist for a travel job in Santa Fe, New Mexico. & Requirements • Specialty: Physical Therapist • Discipline: Therapy • Start Date: 02/10/2025 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment Type: Travel • Location:...
US - NM - NM - Alamogordo
January 24, 2025
Focus Staff is seeking a travel Occupational Therapist for a travel job in Alamogordo, New Mexico. & Requirements • Specialty: Occupational Therapist • Discipline: Therapy • Start Date: 02/10/2025 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment Type: Travel Focus Staff...
MedPro Healthcare Allied Staffing
US - NM - NM - Albuquerque
January 23, 2025
MedPro Healthcare Allied Staffing is seeking a travel Speech Language Pathologist for a travel job in Albuquerque, New Mexico. & Requirements • Specialty: Speech Language Pathologist • Discipline: Therapy • Start Date: 02/24/2025 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days •...
US - NM - NM - Albuquerque
January 24, 2025
Focus Staff is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Albuquerque, New Mexico. & Requirements • Specialty: PCU - Progressive Care Unit • Discipline: RN • Start Date: 02/03/2025 • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, nights • Employment...
US - NM - NM - Santa Fe
January 23, 2025
Magnet Medical is seeking a travel Radiology Technician for a travel job in Santa Fe, New Mexico. & Requirements • Specialty: Radiology Technician • Discipline: Allied Health Professional • Start Date: ASAP • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment Type: Travel An...
US - NM - NM - Santa Fe
January 23, 2025
Ardor Health Solutions is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Santa Fe, New Mexico. & Requirements • Specialty: ED - Emergency Department • Discipline: RN • Start Date: 02/10/2025 • Duration: 13 weeks • 36 hours per week • Shift: 12 hours, nights •...