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:
This position is responsible for second level support of all Clients, Account Management, and Contact Center staff escalated issues. Responsibilities include review, research, and effectively communicating to members and clients, support of Contact Center Management in the efforts to present and develop a multi-channel customer service team, and supporting the assurance of meeting established client service levels and member expectations. Responsibilities:
.Maintains expert knowledge of multi-channel process, to include plan benefit information, customer service skills, phone and computer databases and online support .Cultivates customer trust by providing clients, members and pharmacies with information regarding benefit plans to assure accurate claims processing and client/member satisfaction .Adheres to and reinforces company and department Standard Operating Procedures and training guidelines specific to the multi-channel application and HIPAA compliance .Thorough understanding of NCQA report in order to create and maintain appropriate reporting standards with regard to complaints. Document quality issues as they relate to the concerns of members/clients identifying areas of opportunity .Serves as the primary resolution for escalated calls/e-mails from clients and members, and assists with responding to service/operational issues providing prompt resolution for complete client/member satisfaction .Resolves urgent written or verbal client/member escalations/complaints within a twenty-four hour turn around time. All other escalations need to be resolved in 5 to 10 business days .Interfaces with internal and external Prime resources consistent with SOP's as well as to conduct further investigation and resolution of inquiries. .Ability to respond, research, resolve, and report HIPAA violations and client/member complaints per company policy and guidelines. Identify trends and opportunities for quality improvement as well as initiate and recommend solutions to improve client/member satisfaction .Communicate directly with Account Management for assigned accounts ensuring all contractual obligations are being satisfied .Other duties as assigned Basic Qualifications:
.High School Diploma or equivalent required .Two to three years of Customer Service experience Preferred Qualifications:
.Excellent communication, interpersonal and problem-solving skills .CPhT with previous pharmacy benefit management experience .Previous leadership experience .Client relationship management experience .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 .Strong organizational and follow up skills; ability to effectively multi-task .Ability to maintain confidentiality and appropriately handle sensitive information with tact and discretion 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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