Manager, Operations (Remote)

Posted 5 Days Ago
Be an Early Applicant
Home, KS
74K-118K Annually
Senior level
Insurance
The Role
The Operations Manager is responsible for leading the Benefits Plan Administration team, ensuring operational goals are met, project deadlines are adhered to, managing team performance through metrics, training new analysts, and collaborating with customers to resolve complaints. The role focuses on developing efficient workflows and implementing best practices for team and project management.
Summary Generated by Built In

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

Manager, Operations (Remote)Job Description

  • Operations: Manages team members in the project management, programming, testing and documentation aspects of the analyst responsibilities to drive the highest level of performance and meet or exceed service level agreements; develops, recommends and implements plan(s) of action to implement recommended programming changes to increase efficiency and performance. Reports performance results to team and management. Demonstrates flexibility in assigning resources based on business needs. Creates project plans and performs analysis to ensure project (i.e., migrations, new plan implementations) deadlines are met. Obtains an in-depth working knowledge of the benefits departments’ workflow and the impact to other departments. Adheres to budget allocations.
  • Team Performance and Workforce Management: Manages employee performance through defined employee scorecards and performance metrics. Provides ongoing feedback and coaching to ensure performance targets are met. Recognizes and rewards effectively; provides appropriate levels of direction and support. Consistently follows corporate and departmental polices and guidelines. Utilizes corporate tools for performance appraisals; engages team members in development planning and progress. Identifies training needs within the team; works independently and/or through other sources to develop a training plan. Maintains a positive work environment that supports self-directed teams; provides a structure to optimize the experience, skill, knowledge and capability of the team; facilitates collaboration among team members. Schedules employees, tracks productivity, maintains work schedules, coordinates different activities, and approves time off and overtime. Provides administrative backup support to ensure appropriate workflow is being maintained at all times.
  • Develops and documents workflow, systems requirements, system impact analysis, systems design, process analysis and testing (including reasonableness checks) using software development methodology to provide efficient, cost-effective solutions as directed.
  • Identifies impact of solutions on existing and future systems. May perform operational activities.
  • Identifies reporting needs based on system programming and workflows and documents reporting requirements and testing of new reporting development prior to implementation to Production.
  • Participates in initiatives or projects that support process improvements, leveraging new system capabilities or the integration of data/other applications into existing systems.
  • Collaborates between departmental business owners, end users, IT, Contact Center, Claims and Clinical departments to resolve issues, or develop small to large sized new programs. Participates in full life cycle of projects impacting Plan Administration by performing requirements analysis, process development and design, and unit testing. Participates in initiatives or projects that support process improvements, leveraging new system capabilities or the integration of data/other applications into existing systems.
  • Creates and maintains the necessary functionality in our ticketing system, benefit landscape, and workflows. Conducts root cause analysis, gathering data to pinpoint problem areas on which to focus. Recommends and implements solutions and evaluates results, and implements controls to monitor consistent use of the solution.
  • Data Validation: Performs the technical and administrative functions to lead the Benefit Analysts in organizational data validation projects to support major system enhancements, or release updates. Supports data validation activities when deploying changes to a large number of clients. Leads design of data validation processes to ensure data checks fall within an acceptable range to ensure compliance standards are met. Activities should automate data validation, improve quality, and reduce costs. Assist with phased deployment approach to ease adoption across impacted teams.
  • Audits: Coordinates responses to both external and internal audits. Ensures workflows support compliance, and identifies when audit protocols need to be refreshed to more accurately capture day-to-day procedures. Evaluates audit findings and implements new processes to bring Plan Administration into compliance.

Potential pay for this position ranges from $81,000.00 - $138,000.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law. 

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.

The Company
HQ: Eagan, MN
3,577 Employees
On-site Workplace
Year Founded: 1987

What We Do

Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 20 years.

In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 28+ million members throughout the US.

In addition to core PBM services, we work closely with our clients to implement the right benefit design, clinical and specialty programs, formulary and networks. A few key products:
• NetResults™
• Specialty Drug Management
• Best in Care™
• GuidedHealth®
• Advanced Fraud, Waste and Abuse: Member and Prescriber Investigations
• Prime Analytics™
• CareCentered Contracting™Controlled Substance Management Program

Join us!
Prime is always looking for smart, purposeful people to join our team. We’re growing fast which means there are plenty of opportunities to advance and grow in your career.

At the same time, Prime supports flexibility and offers generous PTO so you can enjoy an enviable work/life balance. We’re a privately held company -big enough to make a difference and small enough for you to have an impact.

Follow Prime on LinkedIn to learn more.

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