Benefits Configuration Analyst

🔥 15 hours ago

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SmithRx

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2018

⚕️ Healthcare Insurance

☁️ SaaS

🤝 B2B

💰 $20M Series B on 2022-03

Healthcare Insurance • SaaS • B2B

SmithRx is a transparent, pass-through pharmacy benefits manager (PBM) that operates independently from insurance companies and pharmacies to align its incentives with self-insured employers and their members. By leveraging modern technology, SmithRx aims to reduce the cost and complexity of pharmacy benefits, ensuring the delivery of effective and low-cost drugs. The company is dedicated to transforming the pharmacy benefits landscape through its flat-rate, transparent pricing model and innovative cost savings programs, which connect members to the lowest cost drugs without the use of spread pricing, rebates, or other tactics. SmithRx's commitment to transparency and superior customer service results in significant savings for employers and a highly satisfactory experience for its members.

📋 Description

• 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.

🎯 Requirements

• 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

🏖️ Benefits

• 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