Remote AVP: Claims & Configuration Leader

Prime Therapeutics; Helena (MT); Remote; USD 164.000 - 279.000; Vollzeit

Zusammenfassung

Prime Therapeutics is seeking an Associate Vice President to lead Claims & Configuration remotely. You will shape strategy, oversee adjudication and configuration capabilities, and drive modernization while aligning with regulatory and client needs.

We seek a leader who can manage complex programs, guide cross‑functional teams, and deliver measurable improvements in quality, efficiency, and customer satisfaction across a national footprint.

Qualifikationen

• Bachelor’s degree in Business, Health Care Administration, or related field; HS diploma or GED required.
• 12+ years in PBM, health plan, or healthcare operations; 8+ years in leadership/people management.
• Eligibility to work in the United States without visa sponsorship.

Aufgaben

• Lead cross-functional teams responsible for claims adjudication and configuration.
• Drive modernization, efficiency, data-driven decisions, and customer experience.
• Govern strategy, roadmap, and governance for claims and configuration capabilities.
• Oversee client benefit plans, formularies, pricing, and utilization rules in systems.
• Prioritize enhancements with leaders to deliver outcomes and mitigate risk.
• Establish KPIs for accuracy, quality, compliance, and service excellence.
• Develop organizational capability through coaching and talent development.
• Perform other duties as assigned.

Kenntnisse

Leadership

Executive communication

Strategic planning

Regulatory compliance

Stakeholder management

Operational excellence

Ausbildung

Bachelor’s degree or higher

HS diploma or GED

Tools

PBM platforms

Benefits configuration systems

Jobbeschreibung

Prime Therapeutics is seeking an Associate Vice President to lead Claims & Configuration remotely. You will shape strategy, oversee adjudication and configuration capabilities, and drive modernization while aligning with regulatory and client needs.

We seek a leader who can manage complex programs, guide cross‑functional teams, and deliver measurable improvements in quality, efficiency, and customer satisfaction across a national footprint.