[Remote] Patient Access Programs Operations Specialist at SmithRx

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

High School diploma
2+ yrs of experience in healthcare or health systems operations function
Proficiency in Mac, MS-Office, G-Suite
Proficiency in Excel and Google Sheets
Experience using Salesforce Service Cloud or other CRM tool (plus)
High attention to detail
Excellent verbal and written communication skills
Self-starter with ability to multitask, prioritize, and manage time effectively
Ability to organize and prioritize multiple deadlines and work independently
Ability to make decisions, suggestions, and solve problems using sound, inclusive reasoning and judgment
Ability to work independently as well as part of an extended, cross-functional team
Passion for helping people
Passion for delivering high quality results

Responsibilities

Conduct audits on program builds across adjudication platforms
Accurately maintain the program database updated and current based on business needs
Assist with aggregating data for Patient Access program billing, and invoicing
Managing and updating program drug lists and spreadsheets
Contact/make outbound calls to pharmacies to reprocess claims for medications as needed
Execute digital communication outreach campaigns
Coordinate incoming emails from pharmacy partners and internal teams with the expectation of resolution
Provide exceptional support in daily operations of the Patient Access Programs
Special projects, general support other ad hoc duties as assigned

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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