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Tufts Health Plan Remote Jobs (NOW HIRING)

Point32health

Eligibility Representative

... Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and ...

Point32health

Contract Manager - Ancillary

Canton, MA · Remote

$94K - $125K/yr

Ability to understand the nuances of Tufts Health Plan's commercial and Medicare Preferred product lines and the unique operational and financial features associated with each * Ability to lead and ...

Tufts Health Plan

SCO RN Care Manager Quincy/Randolph

$87K - $130K/yr

... care plan which ensures quality medical care for the member. The RN CM works closely with the ... Provide targeted health education, proactive strategies for condition management, and communication ...

Tufts Health Plan

Member Service Advocate-27

Customer service experience in health care, call center or corporate office. * Knowledge of medical terminology. * Prior experience training and working in a virtual/remote setting. Skill ...

Bannerhealth

Senior Health Plan Educator

This hybrid role combines strategic curriculum design with a mix of remote work and essential on ... CORE FUNCTIONS 1. Health Plan Curriculum Design: Leads the design and development of innovative ...

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Tufts Health Plan Remote information

What does it mean to work remotely for Tufts Health Plan?

Working remotely for Tufts Health Plan means that employees perform their job duties from a location outside of a traditional office, such as their home. Remote positions may vary by department and generally require a reliable internet connection, appropriate technology, and the ability to work independently. Tufts Health Plan provides support and resources to help remote employees stay connected with colleagues and maintain productivity. This flexibility allows for better work-life balance, but employees are still expected to meet performance standards and participate in virtual meetings and training sessions.

What are the key skills and qualifications needed to thrive in a remote role at Tufts Health Plan?

To excel in a remote position at Tufts Health Plan, you generally need a background in healthcare, insurance, or customer service, along with relevant education or certifications depending on the specific role. Familiarity with health plan management systems, teleconferencing tools, and secure data platforms is typically required. Strong communication, self-motivation, and organizational skills are essential for effective collaboration and independent work. These skills and qualifications are crucial for maintaining productivity, ensuring compliance, and delivering exceptional service in a remote healthcare environment.

What are some common challenges faced when working remotely for Tufts Health Plan, and how can they be addressed?

Remote employees at Tufts Health Plan may encounter challenges such as maintaining clear communication with team members, staying engaged with company culture, and managing work-life boundaries. To address these, the company often provides robust virtual collaboration tools, regular check-ins with supervisors, and opportunities for remote team-building activities. Proactively setting a structured schedule, leveraging available resources, and staying connected with colleagues can help overcome these challenges and contribute to a successful remote work experience.

What is the difference between Tufts Health Plan Remote vs Tufts Health Plan Customer Service Representative?

AspectTufts Health Plan RemoteTufts Health Plan Customer Service Representative
Work EnvironmentRemote, home-basedOffice or remote, depending on company policy
Required CredentialsHigh school diploma or equivalent; healthcare knowledge beneficialHigh school diploma or equivalent; customer service skills
Industry UsageAdministrative, healthcare insuranceCustomer support, healthcare insurance
Job FocusAdministrative tasks, policy management, member supportHandling member inquiries, claims, and coverage questions

Tufts Health Plan Remote positions typically involve administrative and support roles that can be performed from home, requiring healthcare knowledge but often less direct customer interaction. In contrast, Tufts Health Plan Customer Service Representatives focus on direct member support, often in an office or remote setting, emphasizing customer communication skills. Both roles are integral to healthcare insurance operations but differ mainly in daily tasks and work environment.

Infographic showing various Tufts Health Plan Remote job openings in the United States as of August 2026, with employment types broken down into 7% As Needed, 79% Full Time, 7% Temporary, and 7% Contract. Highlights an 100% Remote job distribution.

Senior Underwriter - Health Plan - Remote

Albuquerque, NM • On-site, Remote

Prime Therapeutics LLC
Insurance Services • 1 - 5K employees

7.9

Company rating: 7.9 out of 10

Based on 48 frontline employees who took The Breakroom Quiz

16th of 113 rated pharmacies

People enjoy working here

Good employer

Paid breaks

Learn more about Prime Therapeutics LLCexternal

$81K - $138K/yr

Full-time

Re-posted 29 days ago

Job description

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
Senior Underwriter - Health Plan - RemoteJob Description
The Senior Underwriter is responsible for achieving profit, growth, service and expense objectives through the financial analysis and pricing of Prime's book of business. Under minimal supervision, the Senior Underwriter serves as an expert consultant on matters pertaining to underwriting, performance guarantees and other financial considerations. Provides underwriting services to determine pricing and monitors accounts to ensure they remain on a profitable basis. Maintains and applies knowledge of pricing strategies in the PBM industry. Maintains a positive working relationship with Sales, Marketing and Client Engagement and other key business owners within Prime.
Responsibilities
  • Evaluates the utilization and financial experience of customers and prospects, many of which are very complex
  • Performs claims re-pricing analyses for the most complex external claims data
  • Provides support to Sales, Marketing and Client Engagement, assisting in the development of client presentations and negotiations pertaining to pricing and guarantees
  • Consults with other departments such as Legal, IT, HPS and Marketing, and participates in meetings as required on issues that have financial implications
  • Other duties as assigned

Minimum Qualifications
  • Bachelor's degree in mathematics, accounting, or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
  • 5 years of related work experience in Finance or Accounting
  • Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications
  • Prior work experience in the PBM and/or healthcare industry
  • In-depth knowledge of mathematical applications used in underwriting function is required, including the ability to calculate figures such as discounts, proportions and percentages, as well as the ability to apply basic concepts of business mathematics and algebra in underwriting problems
  • Ability to effectively present information and respond to questions in one-on-one or small group situations
  • Proficient in MS Office applications, particularly Excel, Word and PowerPoint

Preferred Qualifications
  • 2 years as a Senior Underwriter or Benefits Consultant
  • Proficient with Salesforce.com

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 $81,000.00 - $138,000.00 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.
Prime Therapeutics logo

About Prime Therapeutics

Sourced by ZipRecruiter

Prime Therapeutics, located in Eagan, MN, is a pharmacy benefits management company that has been serving the healthcare industry since its foundation. They are an integral participant in the medical sector, specifically in the realm of health insurance. They focus on providing innovative pharmacy benefits and services to more than 30 million members nationwide. Besides their main pharmacy benefit management, they offer mail service pharmacy, specialty pharmacy, benefits management, and consultative engagement services to ensure individuals have continuous access to affordable prescription drugs. Prime Therapeutics, founded around three decades ago, has grown to stand out as a leader in its industry, thanks to its commitment to improving the health of its clients.

Industry

Insurance services

Company size

1,001 - 5,000 Employees

Headquarters location

Eagan, MN, US

Year founded

1987

Social media

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What Prime Therapeutics employees say

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Benefits

Hours and flexibility

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