Remote AVP, Claims & Configuration — Drive Modernization

Prime Therapeutics; Jackson (MS); Remote; USD 164,000 - 279,000; Full time

Job summary

Prime Therapeutics is seeking an Associate Vice President, Claims & Configuration to lead the strategic direction and execution of pharmacy benefits adjudication, benefit configuration, and network operations. The role drives modernization, governance, and client satisfaction across complex platforms.

As a senior leader, you will shape roadmaps, oversee regulatory-compliant configurations, and develop high-performing teams while managing budgets and stakeholder relationships in a remote-capable

Qualifications

• Bachelor's degree in Business, Health Care Administration, or related field required.
• 12+ years in PBM/healthcare operations with large-scale transformations.
• 8+ years of leadership/people management experience.
• Eligible to work in the United States without visa sponsorship.

Responsibilities

• Lead strategic leadership and operations for claims adjudication and configuration.
• Drive modernization and efficiency across claims and configuration ecosystems.
• Own strategy, roadmap, and governance for claims adjudication and configuration.
• Oversee interpretation and implementation of client benefit plans and pricing.
• Collaborate with partners to prioritize enhancements and regulatory alignment.
• Establish KPIs and ensure compliance and service excellence.
• Lead high-performing teams and manage budget and succession planning.
• Perform other duties as assigned.

Skills

Leadership

Communication

Stakeholder management

Regulatory knowledge

Strategic thinking

Education

Bachelor's degree in Business/Health Admin

HS diploma or GED

Job description

Prime Therapeutics is seeking an Associate Vice President, Claims & Configuration to lead the strategic direction and execution of pharmacy benefits adjudication, benefit configuration, and network operations. The role drives modernization, governance, and client satisfaction across complex platforms.

As a senior leader, you will shape roadmaps, oversee regulatory-compliant configurations, and develop high-performing teams while managing budgets and stakeholder relationships in a remote-capable