Pharmacy Network Pricing Analyst

10 hours ago

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SmithRx

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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.

51 - 200 employees

Founded 2018

⚕️ Healthcare Insurance

☁️ SaaS

🤝 B2B

💰 $20M Series B on 2022-03

📋 Description

• Develop and maintain complex MAC models and processes to support reimbursement strategy. • Execute, implement, and optimize current and future network and pricing innovations. • Ensure all pricing strategies adhere to contractual agreements while maximizing profitability and driving cost savings. • Develop capabilities specifically targeted to achieve the efficient and effective application of the company’s products and services. • Provide assistance and coordination to the Pharmacy Network team in weekly process tasks. • Run weekly automated pricing tasks to ensure process accuracy and implementation. • Gather input data for weekly processes from pricing resources and pharmaceutical data sources. • Collaborate with the legal team to ensure strict compliance with MAC appeals and state reimbursement regulations. • Create detailed procedural documentation covering all automation and analytical tasks for audit and compliance needs. • Perform pharmacy analytics reporting and modeling related to MAC Management. • Develop, maintain, and distribute ad-hoc reports and financial models as needed. • Support the pharmacy pricing appeals process, including receiving/sending communications and compiling necessary data for automated processes. • Work with key stakeholders to create automation around core business processes. • Contribute to ongoing financial reporting efforts.

🎯 Requirements

• Experience: Bachelor’s Degree OR 3-5 years of relevant experience in a financial analysis, pricing, or network management role within the PBM, health plan, or pharmacy industry. • Analytical Acumen: Strong mathematical, statistical, computer science, or economic acumen to assist in overall financial brand and generic pricing management. • Core Competencies: Strong analytical, detail-oriented, and problem-solving skills. • Organizational Skills: Ability to organize and manage multiple priority tasks simultaneously. • Problem Solving: Demonstrated ability to apply critical thinking and problem-solving skills in unstructured situations. • Data Management: Strong background in financial reporting and data management best practices.

🏖️ Benefits

• 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 • Paid company holidays • Wellness Benefits • Commuter Benefits • Paid Parental Leave benefits • Employee Assistance Program (EAP) • Well-stocked kitchen in office locations • Professional development and training opportunities