Network Pricing Specialist

Post Date

Jul 27, 2023

Location

Saint Paul,
Minnesota

ZIP/Postal Code

55121
US
Jun 23, 2025 Insight Global

Job Type

Contract,Perm Possible

Category

Insurance

Req #

MSP-640215

Pay Rate

$16 - $25 (hourly estimate)

Job Description

Prime Therapeutics is seeking a highly-skilled Network Pricing Specialist to join one of our largest national healthcare clients for a remote opportunity. You will be responsible for working under the direction of the PMB Operations leadership team to configure network pricing rates within RxClaim for their peak season. This team uses cutting edge technology and is working on automating various processes to increase efficiencies across the organization. On a day to day basis you will code network pricing plans for various clients, and work in tandem with the quality assurance team to ensure data is at a 98% accuracy rate. This team has a robust training and development program that lasts for the first 4-7 weeks, no previous experience within PBM Ops is necessary, however any healthcare background is encouraged. This position is currently slated as a contract role, however there is a high likelihood that you could be converted to a permanent employee after the initial contract duration.

Hours: The company's core hours are 9:00 AM-3:00 PM, so there is flexibility with start and end time as long as you work 8 hours daily, and start work no later than 9 am, and leave work no earlier than 3 pm each day. These hours will go into effect after the training period.
Training Hours: 8:00-5:00 PM, Monday-Friday for the first 4 weeks.

About PBM Ops:
Prime Therapeutics, one of our top health care clients, is seeking a talented professional to join their PBM Ops vertical as a Network Pricing Specialist, to assist with the upcoming Peak Season beginning in Summer 2023 and lasting through early 2024. Within PBM Ops, the overall goal is to ensure that their system, RxClaim, is up-to-date and accurate so that insurance claims process through correctly and the member is paying what they should, and the insurance company is paying what they should.

Required Skills & Experience

Requirements
-Associates or Bachelors degree in IT, business, analytics or related area of study, or equivalent combination of education and/or pharmacy operations and/or healthcare experience
-Proficiency in Microsoft Word and Excel
-Excellent excel skills

Soft Skills Needed:
-Analytical and problem-solving skills
-Attention to detail
-Organizational Skills with the ability to work on multiple projects simultaneously
-The ability to work in a team setting and on an individual basis.

Nice to Have Skills & Experience

-Exposure to Alteryx
-Exposure to Sql

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.