[Remote] Benefits Configuration Analyst at SmithRx

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

4+ years of experience in payer/claims and benefit configuration
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 - solutions-oriented problem solver and efficiency driven
Flexible, dependable, adaptable, and able to respond under the pressure of a fast-paced technology company
Must be based in one of the following states: Arizona, Arkansas, California, Colorado, Florida, Georgia, Kansas, Minnesota, Missouri, Nevada, New Jersey, Ohio, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin

Responsibilities

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 assigned accounts 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 the 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

Skills

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.

San Francisco, CaliforniaHeadquarters

2016Year Founded

$94.8MTotal Funding

SERIES_CCompany Stage

HealthcareIndustries

201-500Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Health Savings Account/Flexible Spending Account

Unlimited Paid Time Off

Paid Holidays

Wellness Program

Commuter Benefits

Parental Leave

Mental Health Support

Professional Development Budget

Risks

Increased competition from technology-driven PBMs like Capital Rx could erode market share.

Rapid technological advancements may require costly updates to SmithRx's platform.

Potential regulatory scrutiny on PBM pricing models could impact SmithRx's business model.

Differentiation

SmithRx uses a transparent 'Pass Through Pricing' model, unlike traditional PBMs.

The company leverages real-time data for efficient pharmacy benefit management services.

SmithRx offers concierge-level service, enhancing customer satisfaction and support.

Upsides

SmithRx secured $60M in Series C funding, indicating strong investor confidence.

Partnership with Banjo Health enhances prior authorization processes using AI technology.

Collaboration with TheracosBio offers cost-effective drug options for Type 2 Diabetes.

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