AVP Claims Block Owner

🔥 15 hours ago

🇺🇸 United States – Remote

💵 $164k - $279k / year

⏰ Full Time

🔴 Lead

👔 Vice President

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Prime Therapeutics

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1998

⚕️ Healthcare Insurance

💊 Pharmaceuticals

☁️ SaaS

Healthcare Insurance • Pharmaceuticals • SaaS

Prime Therapeutics is a trusted pharmacy solutions provider dedicated to transforming health care through innovation and transparency. The company offers a wide range of services including clinical solutions for improved member outcomes, drug access and affordability, specialty drug management, and condition management for chronic health issues. With over 7,000 employees, Prime Therapeutics aims to challenge norms in the pharmacy industry, providing exceptional experiences and simplifying the complex for millions across the nation. Their mission goes beyond profit, focusing on creating transformative impacts with long-term solutions, utilizing modern technology and holistic approaches in specialty pharmacy management. Owned by mission-driven partners, Prime Therapeutics emphasizes true transparency and conflict-free service, fostering a culture of care and shared purpose in health care.

📋 Description

• Define and lead the multi-year claims technology and capability strategy, including roadmap development for claims platforms • Lead and communicate the enterprise vision for claims block, ensuring alignment to roadmap across business units • Establish clear delivery boundaries and expectations in partnership with account management • Drive education, communication, and adoption strategies across business units and functional teams • Partner with Claims Operations, Configuration Operations, and Strategic Solutions teams to lead large-scale, high-impact initiatives • Assess and manage external partner impacts and dependencies

🎯 Requirements

• Bachelor's degree in Business, Healthcare Administration or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma from an accredited school or GED is required • 12 years of work experience in project management, portfolio management or operations • 8 years of leadership/people management experience • Must be eligible to work in the United States without the need for work visa or residency sponsorship

🏖️ Benefits

• Health insurance • 401(k) matching • Paid time off