Performance Guarantee Analyst Sr - Remote

Prime Therapeutics; Lansing (MI); Remote; USD 81,000 - 138,000; Full time

Job summary

A healthcare solutions company is seeking a Performance Guarantee Analyst Sr to collaborate with various business sectors, ensuring accurate reporting of performance outcomes. The role requires a Bachelor's degree and 5 years of relevant experience in the healthcare sector, particularly in Pharmacy Benefit Management. The ideal candidate will have strong analytical and communication skills. This position offers a salary ranging from $81,000 to $138,000, and the ability to work remotely.

Qualifications

• 5 years of experience in interpreting contractual or process requirements.
• Experience in Pharmacy Benefit Management (PBM) or healthcare industry.

Responsibilities

• Track, monitor, audit, and report performance outcomes.
• Collaborate with business areas to support financial risk assessments.
• Manage performance guarantee data governance and audit requests.

Skills

Microsoft Word

Excel

Power Point

Visio

Analytical skills

Communication skills

Education

Bachelor's degree in business or related area

Job description

Overview

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

Performance Guarantee Analyst Sr - Remote

Job Description

The Senior Performance Guarantee Analyst is responsible for collaborating with Client Engagement and individual business areas to track, monitor, audit, and report metric-based performance outcomes as they relate to client performance requirements. This position partners with client stakeholders at all levels to ensure Performance Guarantee (PG) risk is accounted for and reporting is accurately represented.

Responsibilities

• Execute or support the financial risk assessment on each PG for Request for Proposal (RFP) and Contracting process for performance guarantees for all clients and all lines of business.
• Execute monthly close processes for all clients and lines of business; calculate, track, and report penalties for missed and forecasted performance guarantees; coordinate with data-stagers and red-light responders on missing or questionable data entries and collaborate with General Management teams to ensure responses are acceptable for client visibility.
• Manage the shared mailbox; triage, respond to, and track PG queries.
• Manage the performance guarantee data governance and audit request processes to ensure the integrity of how data is reported.
• Establish collaborative relationships across Prime, spanning all levels in the organization, by providing a variety of support services including consultation, analysis, coaching, facilitation, etc.
• Develop, maintain, and implement PG processes, policies, procedures, and plans; identify/implement process improvement opportunities to improve efficiency and/or quality; lead the approval, documentation, and implementation process for changes to standard performance guarantees.
• Lead the intake of client PG changes (new contracts, renewals, terminations) into Prime’s Performance Quality Management (PQM) system that includes the setup of metrics and targets to measure PG success; communicate and track approval of the setup with all stakeholders.
• Other duties as assigned

Minimum Qualifications

• Bachelor's degree in business or related area of study, or equivalent combination of education and/or relevant work experience
• 5 years of work experience interpreting contractual or process requirements, data validation, data analysis and/or managing end-to-end projects related to quality metrics and/or performance
• Pharmacy Benefit Management (PBM) or healthcare industry experience

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

Additional Qualifications

• Proficient in Microsoft Word, Excel, Power Point, and Visio
• Strong verbal and written communication skills; ability to communicate complex information in a manner that promotes credibility
• Ability and desire to drive solutions for complex business needs
• Familiarity with project management concepts, competencies and skills; proven ability to handle multiple projects simultaneously and work under strict timeframes and under pressure
• Solid analytical skills with strong attention to detail

Preferred Qualifications

• Experience leading cross-functional work efforts
• Experience in meeting facilitation, conflict management, and consensus building
• Experience in presenting and interacting with executive and senior leadership team members; professionally and vocally represent the PG team

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 $81,000.00 - $138,000.00 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.

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.

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.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email [e-mail].