Benefits Configuration Analyst
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:
- Integrity: Always operate with honesty and transparency so we earn the trust of our clients.
- Courage: Demonstrate the courage needed to take on a broken industry and continuously improve what we offer to optimize health outcomes.
- Together: Foster a collaborative and inclusive environment that values teamwork, respect, and open communication, and encourages creativity and diversity of thought.
Job Summary: 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. In order to be eligible for this position applicants must be based in one of the following states: Arkansas, Arizona, California, Colorado, Florida, Georgia, Kansas, Minnesota, Missouri, Nevada, Ohio, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin. Job Summary: 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 configurationWhat you will 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, and Life Insurance and AD&D Insurance
- Flexible Spending Benefits
- 401(k) Retirement Savings Program
- Short-term and long-term disability
- Discretionary Paid Time Off
- 12 Paid Holidays
- Wellness Benefits
- Commuter Benefits
- Paid Parental Leave benefits
- Employee Assistance Program (EAP)
- Well-stocked kitchen in office locations
- Professional development and training opportunities
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