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Prime Therapeutics

Contracts Analyst Sr, TennCare - Remote

Posted 13 Days Ago
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In-Office or Remote
Hiring Remotely in Home, PA
74K-118K Annually
Senior level
In-Office or Remote
Hiring Remotely in Home, PA
74K-118K Annually
Senior level
Leads service provider contract implementation, maintenance, modifications, compliance monitoring, incentives, and annual deliverables. Analyzes provider performance, pharmacy data, costs, utilization, and contract impacts while coordinating with Finance and internal teams. Supports RFPs, system initiatives, and contract coordinators. Serves as the primary business owner for state, CMS, internal, and program integrity audits. Requires contracting or business process administration experience in PBM or another regulated industry.
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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 - RemoteJob 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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