Functional Business Consultant - Remote
About The Position
At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Functional Business Consultant - Remote Job Description The Functional Business Consultant serves as a subject matter expert for assigned business systems or processes, providing guidance on internal and client projects, regulatory requirements, and process improvements. This role leverages advanced research, impact analysis, and issue resolution to enhance business operations, while also managing documentation, communications, training, testing, audits, and ongoing system support. The position ensures compliance, strengthens client interaction, and develops reporting solutions to drive organizational efficiency and effectiveness.
Requirements
- Bachelor's degree in business administration, IT or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
- 2 years of work experience in business analysis, project management, regulatory, and/or process improvement to include:
- 1 year of functional experience in at least one of the following areas: claims, eligibility, product, benefits, implementations
- Must be eligible to work in the United States without the need for work visa or residency sponsorship
- Ability to establish and maintain relationships with clients
- Knowledge of and ability to understand highly analytical pharmaceutical claims data and general understanding of medical claims data
- Ability to conduct self-learning of new processes and software to solve analytic problems
- Interpersonal skills necessary to drive results and deliver on commitments
- Skilled in meeting facilitation, conflict management, and consensus building
- Ability to handle multiple projects simultaneously and to work under pressure with strict timelines in a fast-paced work environment
- Excellent verbal and written communication skills with prior experience giving presentations
- Proficiency in Microsoft Word, Excel, PowerPoint, Project and Visio skills
- Ability to perform regulatory or audit research
Nice To Haves
- Claims system proficiency
- Previous PBM or healthcare experience
- Experience using queries
- Regulatory, Compliance, or Audit experience
Responsibilities
- Serve as subject matter expert for assigned business systems or processes, developing requirements, specifications, process flows, and supporting change management or project delivery
- Partner with internal and external stakeholders to maintain and enhance existing applications, resolving business and technical issues to improve efficiency and user experience
- Research, evaluate, and recommend improvements to processes and system functionality, applying operational best practices and aligning with business needs
- Conduct system testing, including creation of test plans and cases, execution of User Acceptance Testing (UAT), and documentation of results to ensure quality and compliance
- Collaborate across teams to monitor and ensure compliance with applicable regulations, laws, and audit requirements, while mitigating risk through proactive process improvements
- Contribute to standard operating procedures (SOPs) and documentation to support ongoing system governance and knowledge transfer
- Other duties as assigned
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
501-1,000 employees
