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 Initial Review Pharmacy TechnicianJob Description Plays a key role in medical and pharmacy management initiatives critical to the company achieving revenue goals and operational objectives. Responsible for executing utilization management programs on behalf of health plan/payor customers, while utilizing additional clinical knowledge pertaining to a set list of managed medications across all health plans, with additional training for each medication and therapeutic class. Primary activities center on reviewing both prospective and retrospective requests for therapeutic appropriateness using sound clinical criteria. Responsible for making and receiving calls to and from physicians, patients, and pharmacies to gather additional clinical information to determine medication reimbursement. Recommendations will be based on an in-depth understanding of specific specialty medications and industry guidelines, on both pre- and post-service requests. Coordinates with operations, clinical, medical, reporting and other internal departments as needed. Responsibilities - Reviews pertinent patient information and checks appropriateness using clinical criteria. Makes approval recommendations on all services that meet clinical review criteria. Refers all cases not meeting clinical criteria to pharmacist clinical reviewer. - Practices and maintains the principles of utilization management by adhering to the company policies and procedures. Upholds clinical integrity of pharmaceutical solutions by participating in on-going training programs to ensure quality performance in compliance with applicable standards and regulations. Expert within the organization. - Conducts Program Integrity Audits including outreach and review of medical records to audit authenticity of provider response during Prior Authorization and reporting results to client. - Assists with the documentation and implementation of both written and verbal communications to physicians/prescribers and assists in the maintenance of the edits and data elements that support the edits. - Available for consultation in pharmacy related questions to resolve claims submission related to medication edits. - Contacts physicians/prescribers to obtain pertinent clinical history/information. Provides optimum customer service through professional/accurate communication while maintaining NCQA and health plan`s required timeframes. - Regularly reviews and monitors information on pended claims identified as outliers by internal and/or external analysis of pharmacy claims data. - Supports Intake call volume and order entry if necessary. - Determines eligibility for medication reimbursement based upon established clinical criteria and clinical knowledge and enters approvals or denials in the system. - Electronically documents both written and verbal communications with physicians, their staff, cardholders, and pharmacies. - Escalates medical exception requests to nurse, pharmacist or physician on the utilization review clinical team when further review is necessary. - Other duties as assigned. Minimum Qualifications - HS diploma or GED is required - 4 years of Pharmacy Experience - CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy - Must be eligible to work in the United States without the need for work visa or residency sponsorship Additional Qualifications - Must have an active pharmacy technician licensure or registration in accordance with state requirements. - If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or - registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT). - In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT). - Minimum of 2 years of pharmacy experience without a Bachelors degree OR 2 years of pharmacy experience with a - Bachelors degree in Science, Health, Medical or related field. - Specialty or retail pharmacy experience, previous reimbursement experience, and/or working in a health plan/health care setting. - Experience as Pharmacy Technician, Utilization Management or Customer Service in a high-volume, multi-functional call center environment. - Must be comfortable with using computers and the internet; basic skills with Microsoft office products and ability to quickly learn proprietary systems, typing. - Strong team orientation with respect for all members. - Excellent verbal and written communications skills. - People skills are essential that allow for the successful consultation with physicians, prescribers and pharmacists and for successful collaboration with company employees and external vendors who do not directly report to this position. - Analytic skills which can translate into practical and pragmatic recommendations. - In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques and medical terminology. Preferred Qualifications - Oncology pharmacy or other clinical pharmacy experience. - 4 years of pharmacy experience Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job. Potential pay for this position ranges from $23.08 - $37.02 based on 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 (https://www.primetherapeutics.com/benefits). 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. Positions will be posted for a minimum of five consecutive workdays.

Overview Ansible Government Solutions, LLC (Ansible) is currently recruiting Remote Medical Support Assistants (Remote Medical Receptionists) that is to support the Oregon VA Healthcare System. Working hours are Mon-Fri, 7am-6pm (8-hour shifts within this window). If you accept employment with Ansible, you must also acknowledge that any assigned schedule is subject to change at the direction of either Ansible or its customers. Ansible Government Solutions, LLC (Ansible) is a Service-Disabled Veteran-Owned Small Business (SDVOSB) providing Federal customers with solutions in many arenas. Our customers face wide-ranging challenges in the fields of national security, health care, and information technology. To address these challenges, we employ intelligent and committed staff who take care of our customers’ success as if it is their own. Responsibilities - Provide front‑line administrative and clerical support for VA clinics and Community Care scheduling - Perform consult intake, patient/provider outreach, appointment scheduling, and follow‑up - Manage appointment schedules, Electronic Wait List, recall lists, and pending consults - Accurately schedule appointments within VA timeliness standards (≤ 7 calendar days from consult entry) - Answer phones professionally, screen calls, and route or resolve inquiries appropriately - Verify patient identity using two VA‑approved identifiers - Update and validate demographic and insurance information during patient interactions - Explain VA insurance collection requirements to Veterans and families - Enter and maintain accurate documentation in CPRS / EHRM - Collaborate with VA clinical staff and interdisciplinary care teams - Assist with clinic access contingency plans, including rescheduling or shifting patients as needed - Escalate scheduling or access issues to VA supervisors per SOP - Maintain high customer service standards when interacting with Veterans, families, and staff - Meet VA performance standards for accuracy (≥98%), responsiveness, and customer service - Participate in required meetings, huddles, reporting, and quality improvement activities - Complete related administrative duties as assigned to support daily operations Qualifications - High School diploma or GED equivalent. - Proficiency in written and spoken English. - Minimum typing speed of 50 words per minute. - Basic computer proficiency, including Microsoft Office applications. - Basic knowledge of medical terminology. - Minimum 6 months of customer service experience. - Ability to work remotely and independently in a professional setting. - Ability to obtain and maintain a favorable VA background investigation (NACI) and PIV credential. - No physical or health restrictions that would interfere with job performance. - Ability to complete all required VA onboarding, security, privacy, and mandatory training prior to and during assignment. - U.S. citizenship required. All candidates must be able to: - Sit, stand, walk, lift, squat, bend, twist, and reach above shoulders during the work shift - Lift up to 50 lbs from floor to waist - Lift up to 20 lbs - Carry up to 40 lbs a reasonable distance - Push/pull with 30 lbs of force All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Job Requisition ID: 2026-225 Requisition Begin Date: 3/17/26 Requisition End Date: 4/30/26 (Posting may close earlier if filled or if business needs change.) Help us Insure it Tokio Marine HCC is a global industry-leading specialty insurance group, backed by the strength and stability of the Tokio Marine Group. Offering over 100 classes of specialty insurance, we empower clients to pursue opportunities confidently through our “Mind Over Risk” philosophy. More than an insurance company, we are an organization built on innovation, unity, and trust. At our core, we are Always Advancing, driven by innovation and an entrepreneurial spirit that keeps us moving forward. Our people are Experts in Tomorrow, using curiosity and smart working to anticipate what’s next. With a culture rooted in Reaching Out, we foster genuine collaboration and support, ensuring every individual has the opportunity to succeed and make a difference. Role Overview Relying on limited experience and knowledge, this role is responsible for accomplishing the following assignments. These assignments are varied in nature. Key Responsibilities - Review issues forwarded from the Underwriting group that includes complex diagnoses and then estimate ongoing costs. Provide this information to the specific Underwriter. - Act as support for renewal underwriting. This includes, but is not limited to, assessing the severity code on on-going claims, adjusting reserves for accuracy, evaluating new referrals if effective within sixty days of notice, and assigning recommended specifics, if requested. - Educate Underwriters on how to recognize specific diagnoses and severe types of diagnoses to ensure these are identified and properly quoted during the underwriting process. What You Bring - 4 Year / Bachelors Degree in a related field or the equivalent education and/or experience - Required Registered Nurse (RN) designation - 5 Years Relevant and progressive clinical experience, preferably in an acute care or manage care/setting - 5 Years Clinical experience, preferably in an acute care setting and/or managed care setting - Strong medical knowledge including International Classification of Diseases (ICD), Current Procedural Terminology (CPT), medical terminology, COBRA, and HIPAA - Strong understanding of operations of third-party administrators(TPAs) and managing general underwriters (MGUs) - Knowledge of Carrier and Reinsurer reporting and contractual requirements - Possess and have ability to apply broad knowledge of principles, practices, and procedures - Excellent written and verbal communications skills with an emphasis on confidentiality, tact, and diplomacy - Exceptional organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously - Knowledgeable of industry changes, legal updates, and technical developments related to applicable area of the Company's business to proactively respond to changing business environment - Intermediate proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word) - Occasional travel (up to 10% of time) What We Offer - Competitive salary and comprehensive benefit package - Strong learning culture with ongoing development opportunities - Opportunities for growth and career advancement - Comprehensive medical, vision, and dental coverage, with eligibility beginning on your first day of employment - Basic life and disability insurance - 401(k) plan with 6% company match - 20 days of PTO, two floating holidays, approximately 11 paid holidays, and volunteer time off - Paid parental leave - Access to our award-winning wellness program, including mental health services, fitness network membership, and a complimentary Headspace subscription - Student loan matching program - Employee discount program - An opportunity to do meaningful work and love what you do Pay Transparency The pay range for this position is $71,000-$156,600, which includes geographic adjustments, where applicable. The pay range is the range THMCC, in good faith, believes is the range of compensation for this role at the time of this posting. The hired applicant will be offered pay within the entire range based on the candidate’s geographic location, qualifications, work experience, education, and/or skill level. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of color, race, sex, national origin, sexual orientation, religion, age, veteran status, disability, pregnancy, citizenship status, genetic information, or any other basis protected by federal, state, or local pay equity laws. Disclaimer WA, NV, IL, MN, OH , NY, CT, D.C., RI, MA, HI, MD, NJ, VT → Use Federal and State Compliance language. As an insurance company, we comply with certain federal, state and local laws such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e)), which restricts our ability to employ individuals with certain types of criminal convictions. Where not restricted by law and for criminal history not covered by this law, the Company will consider qualified applicants with arrest or conviction history in compliance with applicable law. Remote National → Use Conditional Background Check language. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if the Company is concerned about a conviction that is directly related to the job, you will be given the chance to explain the circumstances surrounding the conviction or challenge the accuracy of the background report. The Company will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e))(the “VCCLEA”), which restricts financial institutions and insurers such as TMHCC from employing individuals with certain types of criminal convictions. Where the hiring and employment of individuals is not restricted by the foregoing, the Company will consider qualified applicants with arrest or conviction history in compliance with applicable law such as the California Fair Chance Act, the Los Angeles Fair Chance Initiative for Hiring Ordinance, the Los Angeles County Fair Chance Ordinance, the San Diego Fair Chance Ordinance, and the San Francisco Fair Chance Ordinance.] About Us Tokio Marine HCC is a leading specialty insurance group with offices in the United States, the United Kingdom, Europe, and other exciting locations. With the strength and stabilitythat comes from being a member of the Tokio Marine Group, and more than fifty years of growth, profitability, and stability, we offer important insurance products that most people don’t even know exist. Every policy we write is special, enabling our clients to do amazing things. TMHCC Stop Loss, a $2 Billion division within TMHCC, leads the way in providing medical stop loss insurance sold to employers. Medical Stop Loss provides an added layer of insurance protection to employers who choose to self-fund their health benefit plans. Self-funding can incur risks from catastrophic claims, and Medical Stop Loss insurance from Tokio Marine HCC is designed to protect employers from that risk. Applying our Mind Over Risk philosophy to writing insurance allows our customers to take on opportunity with confidence. That philosophy defines our way of thinking, unites us as a team, and differentiates us from our competitors. We are much more than just an insurance company; we are a good company. Equal Opportunity Employer TMHCC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age, ancestry, citizenship, color, family or medical care leave, gender identity, genetic information, marital status, medical condition, national origin, physical or mental disability, protected veteran or military status, race, ethnicity, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable local laws, regulations and ordinances. #LI-CM3 #stoploss1

Anticipated End Date: 2026-03-31 Position Title: Pharmacy Benefits Investigation - BioPlus Specialty Pharmacy Job Description: Pharmacy Customer Associate II LOCATION: This is a virtual eligible role. You must be within a reasonable commuting distance of one of our offices. HOURS: 11:30 am - 8:30 pm, ET, Monday through Friday. TRAINING: 5 Weeks, training will be conducted during regular business hours, 8:00 am - 5:00 pm or 9:00 am - 6:00 pm, ET. Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Pharmacy Techs! The Pharmacy Customer Associate II is responsible for responding to basic customer questions via telephone and written correspondence regarding pharmacy retail and mail order prescriptions. Primary responsibilities include, but are not limited to: - Develops and maintains positive customer relations and coordinates with functions within the company to ensure customer requests are handled and resolved appropriately and in a timely manner. - Interacts with internal and external customers (could include subscribers, providers, group or benefit administrators, physician offices, third party representatives, and other Blue Cross Plans) to provide claims, customer service, and/or membership support. - Completes necessary research to provide proactive, thorough solutions. - Displays ownership of service requests ensuring high quality resolution and follow-thru. - Supports and guides the customer with their personal options and decisions and helps the customer become knowledgeable and confident about using technology, tools and resources available to them. Required Qualifications - Requires a HS diploma or equivalent and previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background. Preferred Qualifications - 2+ years of Specialty Pharmacy experience strongly preferred. - Certified or Registered Pharmacy Technician preferred. - Experience with pharmacy benefits investigation strongly preferred. - Experience processing/interpreting pharmacy claims is very helpful. - Experience with pharmacy prior authorizations and pharmacy billing is very helpful. - Experience working with a variety of therapy types is very helpful. - Strong critical thinking skills are a must for this position. Job Level: Non-Management Non-Exempt Workshift: 1st Shift (United States of America) Job Family: CUS > Care Reps Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.