Director, Payer Relations & Operations, Supply Chain

Remote

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Not SpecifiedCompensation

Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Health-Tech, Pharmacy Benefit Management (PBM), Supply ChainIndustries

Requirements

The ideal candidate will have a strong background and interest in commercial insurance, relationships management, strategy, process development, leading presentations externally and internally, and negotiation. A deep understanding of pharmacy reimbursement, pricing benchmarks, PBM client pricing, and the competitive landscape related to supply chain pricing is required. 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, or Wisconsin.

Responsibilities

The Director, Payer Relations & Operations will serve as the main point of contact for retail pharmacy partners, supporting all aspects of the PBM relationship, including pricing inquiries, contract compliance, audits, and contract implementation. This role will act as an internal liaison between supply chain and other constituents, attending meetings with supply chain partners to present business reviews. Responsibilities include nurturing relationships with retail pharmacy partners and internal stakeholders, leveraging data analytics and economic modeling to drive conversations about the pharmacy benefit offering, driving opportunity growth by opening new channels for sales, collaborating with cross-functional teams, and creating purpose-built content to improve solution knowledge and support the sales process.

Skills

Payer Relations

Supply Chain Management

Pharmacy Benefit Management (PBM)

Contract Compliance

Audit Management

Contract Implementation

Provider Relations

Negotiation

Relationship 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.

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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