Benefits Configuration Analyst

Remote

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Health-Tech, Pharmacy Benefit Management (PBM)Industries

Requirements

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. A minimum of 4 years of experience in payer/claims and benefit configuration is required, along with strong analytical and Microsoft Excel skills. Excellent communication, a self-starter mentality, a solutions-oriented approach, flexibility, dependability, and adaptability are also essential.

Responsibilities

The Benefits Configuration Analyst will support cross-functional teams during implementations and build and manage pharmacy benefit plans on various platforms. This role involves identifying client benefit plan requirements, maintaining accurate benefit configuration, and supporting core benefits operations functions. Responsibilities include organizing benefit configuration, monitoring plan data integrity, assisting with process improvements, maintaining prior authorizations and step therapy rules, grandfathering/transitioning clients, updating formularies, communicating project status, troubleshooting claims adjudication, and supporting new client implementations with testing and post-go-live auditing.

Skills

Benefits Configuration

Pharmacy Benefit Management (PBM)

Health-Tech

Drug Acquisition Platform

Plan Operations

Cross-functional Team Support

Implementation Support

Data Management

Problem-Solving

Communication

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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