Job Description

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
Supervisor - Criteria & Correspondence

The Criteria and Correspondence Supervisor is responsible for oversight and development of the Criteria and/or Correspondence Analyst team. This position ensures the effective delivery of the defined services for new clients and clinical programs. This position is also responsible for addressing escalated Quality Assurance-related issues and client requests.
Responsibilities

• Ensure effective staff is in place to provide defined services by scheduling to adequately support client activities and related requests, conducting interviews and recommending hires, providing coaching and development opportunities, handling discipline and recommending corrective action, and conducting performance reviews
• Manage and facilitate rapid response on criteria and/or correspondence timelines, concerns, trend analysis, implementation time delays, quality initiatives, and process improvement opportunities
• Ensure required systems/equipment for operations are fully functional and escalate issues to minimize client and Clinical Review team disruption
• Lead, prioritize, and delegate work amongst the Criteria and/or Correspondence Analyst team by providing clear direction, setting and measuring performance expectations, and developing talent
• Manage work volume metrics across the Criteria and/or Correspondence Analyst team
• Respond to escalated Quality Assurance and client requests in a timely manner
• Other duties as assigned

Required Qualifications

• Bachelor’s degree in business or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
• Must be eligible to work in the United States without need for work visa or residency sponsorship
• 3 years of related work experience in PBM or healthcare industry

Additional Qualifications

• 1 year of leadership experience in a production or operations environment, health care related field or customer service industry, with strong attention to metric driven management and performance
• Demonstrated ability to make consistent and unbiased decisions based upon appropriate benefit plan criteria
• Excellent interpersonal, verbal and written communication skills with the ability to lead, motivate, coach and provide feedback/assistance
• Ability to work under strict timelines while managing multiple priorities simultaneously
• Ability to present complex material to a wide variety of audiences in plain language

Preferred Qualifications

• National Pharmacy Technician Certification through PTCB or ExCPT (CPhT)
• Experience using RxClaim and CORE
• Experience in benefit design and review process for multiple clients
• Supervisory experience

Minimum Physical Job Requirements

• Ability to work a flexible schedule which may include weekends, holidays, or shifts outside of Prime’s core business hours of 9:00am-4:00pm, and more than 40 hours per week
• Constantly required to sit, use hands to handle or feel, talk and hear
• Frequently required to reach with hands and arms
• Occasionally required to stand, walk and stoop, kneel, and crouch
• Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Reporting Structure

• Reports to a Manager of Operations

Potential pay for this position ranges from $71,700.00 - $107,300.00 based on location, experience and skills.


















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 an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.