Health Individual Marketplace Strategies Principal - Remote

Health Individual Marketplace Strategies Principal

Our work matters. We help people get the medicine they need to feel better and live well. It fuels our passion and drives every decision we make. The Principal of Health Individual Marketplace Strategies leads the development and execution of integration and profitability strategies for clients participating in the Individual and Small Group Exchanges under the Affordable Care Act. This position ensures quality and compliance standards are met while driving successful capability development and execution of the strategies, in support of one or more of Prime's market segments by evaluating market performance of benefits, market share, and competitive position to develop recommendations for improvements to support client strategic goals.

Responsibilities

Collaborate with leadership to identify, develop and optimize segment-specific strategies to ensure Individual Marketplace growth for Health Plan accounts.

Partner with Segment Client Engagement team to review client performance metrics, market analysis, and client best practices to provide client specific recommendations for segment success.

Work with Health Plan clients to ensure short and long-term product performance goals are met, including, but not limited to membership growth, market share and profitability, and benefit designs.

Partner with Compliance and Government Affairs to understand, interpret and effectively communicate complex regulatory policies and contract obligations relevant to the segment, ensuring alignment and informed decision-making.

Ensure timely and accurate development and implementation of federal and state regulatory milestones, deliverables, and requirement changes for assigned Health Plan clients, maintaining compliance and supporting operational readiness.

Collaborate with various business units, cross-functional teams and key stakeholders to ensure timely, accurate and on budget implementation of programs.

Develop and deliver executive-level presentations that communicate business objectives, project status, key challenges and achievements.

Other duties as assigned.

Minimum Qualifications

Bachelor's degree in Finance, Business, Health Care Administration, or related area of study, or equivalent combination of education and / or relevant work experience; HS diploma or GED is required.

7 years of work experience in analytics, account management, product development, project management or consultative roles within healthcare, PBM, specialty pharmacy, health care consulting or other highly regulated industry. Must be eligible to work in the United States without the need for work visa or residency sponsorship.

Additional Qualifications

Ability to work effectively in self-directed environment.

Must possess strong interpersonal skills and demonstrate exemplary public speaking, verbal and written communication abilities.

Ability to influence and present complex data to a wide variety of audiences, including internal and external executives.

Exceptional client relationship management and cross-functional team building skills.

Skilled collaborator with proven ability to reconcile differing perspectives and drive mutually beneficial outcomes.

Advanced business acumen and critical thinking skills.

Preferred Qualifications

Experience in ACA / Health Care Exchange business or other Government Programs lines of business.

Managed care experience.

Experience in Project Management / Ownership.

Experience with analytic tools like SQL programming, GCP, SAS, and visualization tools like Tableau.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer.