Prime Therapeutics LLC

, USA

Job Type:
Full-Time Location:
Omaha, NE / Irving, TX Last Updated:
10/28/2009 Job Description:
Prime Therapeutics LLC (Prime) is an innovative and emerging leader in the pharmacy benefit management (PBM) industry. Our mission is to provide the highest quality care and service for our members and empower clients to make informed decisions in health care management. Our strategy is to integrate pharmacy and health management for clinical, financial and ultimately member gain. We proudly serve over 14.6 million members across the United States. If you are looking to make a difference in the lives of others, along with opportunities to develop and advance your career, come join our rapidly growing and dynamic company. We are headquartered in Eagan, Minnesota with major locations in Nebraska, New Mexico and Texas. Job Summary:
Responsible for effectively communicating client pharmacy benefit information to members and/or participating pharmacy networks. Responsible for ensuring members issues are resolved on the first contact. This includes the management of escalated issues, Prior Authorizations as well as communication with management and Solution Specialists. Key to this role will be the mentoring and assistance provided to the Contact Center Specialist and Supervisors. Resolution Specialists are responsible for meeting established client service level guarantees and meeting defined individual performance goals. Responsibilities:
.Maintains expert knowledge of client pharmacy plan benefit information, prior authorization status, customer service skills, phone and computer databases and online support. .Cultivates customer trust by providing members and pharmacies with information regarding benefit plans to assure accurate claims processing and member satisfaction. .Work with the Clinical Review technicians to ensure that inquiries are handled in a timely and complete manner, triage calls as needed. .Adheres to and reinforces company and department Standard Operating Procedures (SOP) and training guidelines specific to the multi-channel application and HIPAA compliance. .Serves as the primary back up for calls that cannot be resolved by Member or Pharmacy Services Agents. Engages Team Supervisor or other members of Contact Center Management when appropriate. .Interfaces with internal and external Prime resources consistent with SOP's as well as to conduct further investigation and resolution of inquiries. .Assists Team Supervisors in the maintenance of accurate statistical records for the purpose of performance management which may include periodic test calls, analysis, and reporting. Maintains shift records including open inquiry tracking log and Right-Fax administration to assure timely resolution of inquiries. .Other duties as assigned. Basic Qualifications:
.High School Diploma or equivalent required .Two years of Customer Service experience Preferred Qualifications:
.Excellent communication, interpersonal and problem-solving skills. .CPhT with previous pharmacy benefit management experience preferred. .Ability to communicate clearly both orally and in writing to others. .Detail oriented with proven problem solving skills. .Action oriented, ability to implement defined objectives and to act independently WHY WORK FOR PRIME? At Prime Therapeutics, we attract the brightest people - those who want to be involved, empowered and rewarded for their achievements. We value people who are ambitious, adaptable to change and dedicated to excellence. We look for candidates who embrace creativity, challenges and collaboration. Our work facilities are modern, clean and provide our employees with the most up-to-date technology. We have a high-energy, fast-paced culture where we value new ideas, build teamwork, drive results and celebrate our accomplishments. Prime offers a competitive salary with bonus incentives. In addition, Prime provides an excellent benefit package including:
medical, dental, vision, company paid life insurance, company paid disability insurance, generous Paid Time Off, 401(k) with a two component match, tuition reimbursement and more. We are proud to be an EOE/AA employer. We maintain a drug-free workplace and perform pre-employment substance abuse testing.

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