Formulary Operations Analyst
RxSenseSalary not specified
- Full Time
- Junior (1 to 2 years)
Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
Health-Tech, Pharmacy Benefit ManagementIndustries
Requirements
Candidates must possess a minimum of 4 years of experience in payer/claims and benefit configuration, along with strong analytical skills and proficiency in Microsoft Excel. Excellent communication skills, both written and verbal, are essential, including the ability to effectively communicate via face-to-face meetings, conference calls, and written correspondence. A self-starter mentality with the ability to make informed decisions and deliver on commitments is required, as is an execution-focused ethos and adaptability to a fast-paced environment. Applicants must be based in Arkansas, Arizona, California, Colorado, Florida, Georgia, Kansas, Minnesota, Missouri, Nevada, North Carolina, South Carolina, Ohio, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin.
Responsibilities
The Benefits Configuration Analyst will support cross-functional teams during implementations, build and manage pharmacy benefit plans on various platforms, and ensure a high-quality SmithRx product. They will work with clients to identify benefit plan requirements, maintain pharmacy benefit plans, aid in the organization of benefit configuration, assist in determining process improvement efforts, maintain prior authorizations and step therapy rules, grandfather/transition new clients and update formularies, communicate project status, provide insight into changes to improve workflow efficiency, collaborate with member support and customer success teams to resolve inquiries, provide troubleshooting support for claims adjudication, and support new client implementations, conduct go-live testing, and perform post go-live auditing.
Skills
Benefits Configuration
Pharmacy Benefit Plans
Benefits Operations
Cross-functional Collaboration
Platform Management
SmithRx
Pharmacy benefit management with transparent pricing
About SmithRx
SmithRx operates as a Pharmacy Benefit Manager (PBM) that focuses on managing prescription drug plans for self-insured employers and plan sponsors. The company uses a transparent pricing model called "Pass Through Pricing," where it charges only an administrative fee and passes all rebates from prescriptions directly to clients and their members. This model contrasts with traditional PBMs that often inflate drug prices and retain rebates for profit. SmithRx's clients benefit from a technology platform that utilizes real-time data to improve service delivery, ensuring efficient and high-quality pharmacy benefit management. The company also provides a concierge service to enhance support for both members and clients. SmithRx aims to simplify pharmacy benefits while maximizing value for its clients through transparency, advanced technology, and exceptional customer service.
Key Metrics
San Francisco, CaliforniaHeadquarters
2016Year Founded
$94.8MTotal Funding
SERIES_CCompany Stage
HealthcareIndustries
201-500Employees