Configuration Specialist - Plan & Benefits Configuration
CentivoFull Time
Expert & Leadership (9+ years)
Candidates must have 4+ years of experience in payer/claims and benefit configuration. Strong analytical skills, proficiency in Microsoft Excel, and excellent communication abilities are required. Applicants must be based in Arizona, Arkansas, California, Colorado, Florida, Georgia, Kansas, Minnesota, Missouri, Nevada, New Jersey, Ohio, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, or Wisconsin.
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. This role involves supporting the Plan Operations team with core benefits operations, maintaining accurate benefit configuration, identifying and understanding client benefit plan requirements, aiding in the organization of benefit configuration structure, determining process improvement efforts, maintaining prior authorizations and step therapy rules, grandfathering/transitioning new clients, updating formularies, communicating project status, resolving benefit-related inquiries, providing troubleshooting support for claims adjudication, and supporting new client implementations including testing and auditing.
Pharmacy benefit management with transparent pricing
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.