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SmithRx

Benefits Configuration Analyst

Posted 5 Days Ago
Be an Early Applicant
Remote
Hiring Remotely in USA
Mid level
Remote
Hiring Remotely in USA
Mid level
Support implementations and plan operations by building and maintaining pharmacy benefit plans, ensuring data integrity, managing prior authorizations and formularies, troubleshooting claims adjudication, conducting go-live testing and post-launch audits, and collaborating with client, member support, and clinical teams to improve workflows and member experience.
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Who we are:

SmithRx is a rapidly growing, venture-backed Health-Tech company.  Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector by building a next-generation drug acquisition platform driven by cutting edge technology, innovative cost saving tools, and best-in-class customer service.  With hundreds of thousands of members onboarded since 2016, SmithRx has a solution that is resonating with clients all across the country.

We pride ourselves for our mission-driven and collaborative culture that inspires our employees to do their best work. We believe that the U.S healthcare system is in need of transformation, and we come to work each day dedicated to making that change a reality. At our core, we are guided by our Company values of:

  • Integrity: Do the right thing. Especially when it’s hard.
  • Courage: Embrace the challenge.
  • Together: Build bridges and lift up your colleagues.

Job Summary:

Benefits Configuration Analyst

As a Benefits Configuration Analyst, you will support cross-functional teams during implementations and build and manage pharmacy benefit plans on various platforms to ensure a high quality SmithRx product. This role will also be responsible for supporting the Plan Operations team with core benefits operations functions while building and maintaining accurate benefit configuration. 

What will you do:

  • Work with clients, identifying and understanding benefit plan requirements. Build and maintain pharmacy benefit plans for client groups.
  • Aid in the organization of benefit configuration and structure for the accounts assigned by monitoring plan data integrity.
  • Assist in determining process improvement efforts.
  • Maintain prior authorizations and step therapy rules.
  • Grandfather/transition new clients and update formularies with changes at the direction of the clinical team.
  • Communicate project status, escalating issues when appropriate. Provide insight into changes to improve workflow efficiency.
  • Collaborate with member support and customer success teams to review and resolve inquiries related to benefits timely to improve member experience.
  • Provide troubleshooting support for our claims adjudication process.
  • Support new client implementations, conduct go-live testing, perform post go-live auditing and support to ensure plans are configured to confirm accuracy.

What you will bring to SmithRx:

  • 4+ years of experience in payer/claims and benefit configuration required
  • Analytical skills; Microsoft Excel skills; 
  • Strong communication skills via face-to-face meetings, conference calls and written correspondence
  • Self-starter mentality: ability to make informed decisions, find creative approaches to difficult challenges, and deliver on commitments
  • Execution-focused ethos - you are a solutions-oriented problem solver and efficiency driven
  • Flexible, dependable, adaptable, and able to respond under the pressure of a fast-paced technology company

What SmithRx Offers You: 

  • Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, Life insurance 
  • Flexible Spending Benefits 
  • Discretionary Time Off 
  • 401(k) Retirement Savings Program 
  • Paid Parental Leave benefits
  • Professional development and training opportunities 

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