Senior Functional Business Consultant- REMOTE

Lensa; Jefferson City (MO); Remote; USD 81,000 - 138,000; Full time

Job summary

An established industry player is seeking a Senior Functional Business Consultant to join their remote team. In this pivotal role, you'll leverage your expertise in business systems to guide internal clients through compliance challenges while enhancing operational best practices. Your leadership will help ensure regulatory adherence, and your analytical skills will drive process improvements. This position offers a unique opportunity to make a significant impact in the healthcare sector, working with a team dedicated to helping individuals access essential medications. If you're passionate about making a difference and possess strong communication skills, this role is perfect for you.

Qualifications

• 5+ years in business analysis or project management.
• Strong client service skills and relationship building.

Responsibilities

• Serve as a subject matter expert in business systems.
• Lead compliance teams and advise management on regulations.
• Research and resolve complex business and technical issues.

Skills

Business Analysis

Project Management

Process Improvement

Client Service Skills

Communication Skills

Interpersonal Skills

Negotiation Skills

Education

Bachelor’s degree in business or IT

HS diploma or GED

Tools

MS Office

Job description

Senior Functional Business Consultant - REMOTE

2 days ago - Be among the first 25 applicants

Lensa is the leading career site for job seekers at every stage of their career. Our client, Prime Therapeutics, is seeking professionals. Apply via Lensa today!

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

Senior Functional Business Consultant - REMOTE

Job Description

The Functional Business Consultant serves as a business system or business process subject matter expert with a high level of understanding of their assigned area. This position will represent their area of expertise regarding business system knowledge on internal and client projects, regulatory requirements, process improvement, research, root cause analysis, issue resolution, documentation, communication, client interaction, training, testing, support, reporting, and audits.

Responsibilities

• Represent assigned business system or process as a subject matter expert in requirements, system specs, process flows, change management, supporting compliance with Medicaid requirements.
• Provide leadership to compliance teams, role modeling Prime’s expectations.
• Advise management on laws, regulations, policies, and objectives, offering SME insights (e.g., ACA, Government Programs, Compliance).
• Guide internal clients on Medicaid regulatory and contractual compliance.
• Lead the adoption of operational best practices and SOPs related to the assigned system or process.
• Research, identify root causes, and collaborate to resolve complex business and technical issues.
• Ensure prompt resolution for client/member satisfaction.
• Mentor and guide team members as needed.
• Perform other duties as assigned.

Minimum Qualifications

• Bachelor’s degree in business, IT, or related field, or equivalent experience; HS diploma or GED required.
• At least 5 years in business analysis, project management, or process improvement, including:
• 3 years in a relevant area (e.g., compliance, claims, eligibility, benefits).
• Eligibility to work in the U.S. without sponsorship.

Additional Qualifications

• Strong client service skills and relationship building.
• Implementation experience.
• Ability to self-learn new processes/software.
• Excellent interpersonal skills for collaboration.
• Skilled in facilitation, conflict management, consensus-building.
• Ability to handle multiple projects under pressure.
• Excellent communication skills, including presentations.
• Proficiency in MS Office tools.

Preferred Qualifications

• 6+ years in legal or compliance roles in healthcare or regulated industries, with Medicaid and ACA experience.
• Previous PBM or healthcare experience.
• Experience with regulatory laws and guidance.
• Certifications: CCEP, CHC, PMP preferred.
• Strong negotiation and influencing skills.

Physical Job Requirements

• Occasional non-standard hours and travel.
• Constant sitting, speaking, hearing.
• Frequent reaching, occasional standing, walking, stooping, kneeling, crouching.
• Occasional lifting up to 10 lbs.
• Vision abilities include close, distance, color, peripheral, depth, focus.

Reporting Structure

• Reports to a Functional Business Owner, Manager, or Director in relevant departments.

All employees must comply with security and legal requirements, internal policies, and attest to their responsibilities.

Potential pay ranges from $81,000 to $138,000, based on experience and skills.

For benefits and incentives, visit our Benefits Page and click on 'Benefits at a glance'.

Prime Therapeutics is an equal opportunity employer, encouraging diverse candidates to apply. All qualified applicants will receive consideration without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, disability, age, veteran status, or other protected classes.

We welcome applicants with diverse backgrounds, including those requiring reasonable accommodations and those with arrest or conviction records.

Prime Therapeutics is a Tobacco-Free Workplace.

For accommodations during the application process, contact Human Resources at 1.866.469.1257 or [e-mail].