Senior Functional Business Consultant- REMOTE

Lensa; Salt Lake City (UT); Remote; USD 81,000 - 138,000; Full time

Job summary

An established industry player is seeking a Senior Functional Business Consultant to provide expert guidance in business processes and compliance. This remote role involves collaborating with management on regulatory requirements, leading projects, and ensuring client satisfaction. The ideal candidate will have a strong background in business analysis and project management, with a passion for improving operational practices. Join a team that values your expertise and offers a competitive salary and benefits. If you're ready to make a significant impact in the healthcare sector, this opportunity is for you.

Qualifications

• 5+ years of experience in business analysis or project management.
• Bachelor's degree in business administration or related area required.

Responsibilities

• Serve as a subject matter expert in business requirements and compliance.
• Lead and mentor compliance professionals and resolve complex issues.

Skills

Business Analysis

Project Management

Compliance Knowledge

Interpersonal Skills

Client Service Skills

Education

Bachelor's Degree in Business Administration

Equivalent Experience

Tools

Microsoft Office Suite

Job description

Senior Functional Business Consultant- REMOTE

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 with regard to business system knowledge on internal and client projects, regulatory requirements, process improvement, advanced research, root cause analysis, complex issue research, documentation, advanced communications, client interaction, training, testing, ongoing system support, and developing reports and coordinating audits.

Responsibilities

• Represents assigned business system or business process as a subject matter expert in business requirements, system specifications, process flows, process change and/or project management in supporting Compliance with Medicaid requirements.
• Provide direct, or indirect leadership to other compliance professionals, role modeling Prime’s employee and leadership expectations.
• Serves as a consultant to management on laws and regulations, policies, plans, and objectives, providing Subject Matter Expertise in areas such as the Affordable Care Act, Government Programs, and Corporate Compliance.
• Advises internal clients regarding compliance with State and Federal Medicaid regulatory and contractual requirements.
• Provides leadership in identifying and adopting operational best practices and standard operating procedures related to assigned business systems or processes.
• Independently researches, determines root causes, and collaborates to resolve complex business and technical issues.
• Provides prompt and thorough resolution for client and/or member satisfaction.
• May guide, mentor, and direct work of others on the team.
• Other duties as assigned.

Minimum Qualifications

• Bachelor’s degree in business administration, IT, or related area, or equivalent experience; HS diploma or GED required.
• 5 years of experience in business analysis, project management, or process improvement, including at least 3 years in areas such as compliance, claims, eligibility, or related fields.
• Eligibility to work in the U.S. without sponsorship.

Additional Qualifications

• Proven client service skills and ability to build strong relationships.
• Implementation experience.
• Self-directed learning in processes/software to solve analytic problems.
• Excellent interpersonal, communication, and presentation skills.
• Ability to handle multiple projects and work under pressure.
• Proficiency in Microsoft Office Suite.

Preferred Qualifications

• 6+ years in legal or compliance roles within healthcare or regulated industries.
• Experience with Medicaid, ACA, and government programs.
• Legal/regulatory experience with state and federal laws.
• Certifications such as CCEP, CHC, PMP preferred.

Physical Job Requirements

• Occasional non-standard hours and travel.
• Sitting, handling, talking, hearing, reaching, standing, walking, stooping, lifting up to 10 pounds.
• Visual acuity requirements.

Reporting Structure

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

All employees must understand and comply with security, legal, regulatory, and internal policies.

Salary range: $81,000 - $138,000 based on experience.

Benefits details available on our Benefits Page.

Prime Therapeutics is an equal opportunity employer and encourages diverse candidates to apply.