Senior Functional Business Consultant- REMOTE

Lensa; Phoenix (AZ); Remote; USD 81,000 - 138,000; Full time

Job summary

Join a forward-thinking company as a Senior Functional Business Consultant, where your expertise will help shape the future of healthcare compliance. In this remote role, you will leverage your extensive experience to guide internal clients through complex regulatory landscapes, ensuring high standards of service and satisfaction. You will engage in process improvement initiatives, provide mentorship to team members, and work collaboratively to resolve business challenges. This is an exciting opportunity to make a significant impact in a mission-driven organization dedicated to improving lives through better access to medications.

Qualifications

• 5+ years in business analysis or project management in healthcare.
• Strong client service skills and ability to manage multiple projects.

Responsibilities

• Act as a subject matter expert in business systems for healthcare.
• Ensure compliance with Medicaid and regulatory requirements.

Skills

Business Analysis

Project Management

Process Improvement

Client Service Skills

Communication Skills

Conflict Management

Education

Bachelor’s Degree in Business or IT

High School Diploma or GED

Tools

MS Office Suite

Visio

Job description

Senior Functional Business Consultant - REMOTE

Apply now to be among the first 25 applicants for this remote opportunity with Prime Therapeutics, a leading healthcare company dedicated to helping people access necessary medications. We value our mission to improve lives and seek a qualified Senior Functional Business Consultant to join our team.

Job Overview

The Senior Functional Business Consultant acts as a subject matter expert in business systems or processes within the healthcare and compliance sectors. This role involves representing expertise in business system knowledge on internal and client projects, ensuring regulatory compliance, process improvement, research, root cause analysis, documentation, communication, client interaction, training, testing, system support, report development, and audit coordination.

Key Responsibilities

• Serve as a subject matter expert for assigned business systems or processes, supporting compliance with Medicaid and other regulatory requirements.
• Lead or support compliance professionals, modeling Prime's leadership expectations.
• Consult management on laws, regulations, policies, and objectives, providing expertise in areas like ACA, Government Programs, and Corporate Compliance.
• Advise internal clients on Medicaid regulatory and contractual compliance.
• Research, identify, and resolve complex business and technical issues, collaborating with relevant teams.
• Ensure prompt resolution of client and member inquiries, maintaining high satisfaction levels.
• Provide guidance and mentorship to team members as needed.
• Perform other related 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 of experience in business analysis, project management, or process improvement, including 3 years in a relevant healthcare or compliance area.
• Legal authorization to work in the U.S. without sponsorship.

Additional Qualifications

• Strong client service skills and experience in implementation projects.
• Ability to learn new processes/software independently.
• Excellent interpersonal, facilitation, conflict management, and communication skills.
• Capability to manage multiple projects under tight deadlines.
• Proficiency in MS Office Suite and Visio.

Preferred Qualifications

• Over 6 years in healthcare or pharmacy benefit management, with experience in Medicaid, ACA, and regulatory laws.
• Previous PBM or healthcare experience.
• Certifications like CCEP, CHC, PMP are a plus.

Physical and Other Requirements

• Occasional travel and non-standard hours.
• Physical ability to sit, handle, talk, hear, reach, stand, walk, and lift up to 10 pounds.
• Vision capabilities include close, distance, color, peripheral, and depth perception.

Reporting Structure

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

Additional Information

Salary ranges from $81,000 to $138,000 based on experience. Benefits details available on our website. Prime Therapeutics is an equal opportunity employer committed to diversity and inclusion. We welcome applicants requiring accommodations and promote a tobacco-free workplace.