Configuration Specialist - Plan & Benefits Configuration
Centivo$80,000 - $90,000/year
Full Time
Expert & Leadership (9+ years)
Not SpecifiedCompensation
Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Health-Tech, HealthcareIndustries
Requirements
- Bachelor's degree or equivalent work experience required
- 5+ years of experience in benefits configuration with a healthcare or health insurance organization
- 2+ years' supervisory experience in appropriate PBM or Medical Insurance environment preferred
- Ability to analyze benefit plan design and configuration rules within an automated claims processing system
- Ability to maintain production levels and quality goals
- Robust analytical skills; advanced skills in Microsoft Excel
- Excellent organization
Responsibilities
- Manage team members in the delivery of benefit configuration and documentation aspects of the plan build and maintenance responsibilities to drive the highest level of performance and meet or exceed service level agreements
- Manage employee performance through defined employee scorecards and performance metrics
- Provide ongoing feedback and coaching to ensure performance targets are met, provide appropriate levels of direction and support to your team members as needed
- Schedule employees, track productivity, maintain work schedules, coordinate different activities, and approve time off and overtime
- Participate in initiatives to support process/workflow improvements, leverage new system capabilities within work processes, and consistently institute best practices within the function
- Work with clients, identifying and understanding benefit plan requirements. Build and maintain pharmacy benefit plans for client groups
- Own all aspects of benefit configuration organization and structure for accounts by monitoring plan data integrity
- Provide leadership support to team members for escalations and complex configuration requests
- Communicate to leadership on project status, escalating issues when appropriate, and drive changes to improve workflow efficiency
- Be accountable for ensuring review and resolution of inquiries from internal teams such as member support and customer success are completed timely to improve member experience
Skills
Key technologies and capabilities for this role
Questions & Answers
Common questions about this position
What is the salary or compensation for the Lead, Benefits Configuration role?
This information is not specified in the job description.
Is this a remote position or does it require office work?
This information is not specified in the job description.
What skills or experience are required for this role?
The role requires experience managing teams, building and maintaining pharmacy benefit plans, coaching and developing analysts, and supporting client implementations and operations.
What is the company culture like at SmithRx?
SmithRx has a mission-driven and collaborative culture guided by values of Integrity, Courage, and Together, emphasizing teamwork, ethical leadership, resilience, and shared success.
What makes a strong candidate for this position?
Strong candidates have leadership experience in managing teams, delivering benefit configuration for client implementations, driving performance through metrics and coaching, and improving processes in pharmacy benefits operations.
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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