SmithRx

Pharmacy Benefits QA Analyst

Remote

Not SpecifiedCompensation
Mid-level (3 to 4 years)Experience Level
Full TimeJob Type
UnknownVisa
Health-Tech, Pharmacy Benefit ManagementIndustries

Who We Are

SmithRx is a rapidly growing, venture-backed Health-Tech company. Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector by building a next-generation drug acquisition platform driven by cutting edge technology, innovative cost saving tools, and best-in-class customer service. With hundreds of thousands of members onboarded since 2016, SmithRx has a solution that is resonating with clients all across the country.

We pride ourselves for our mission-driven and collaborative culture that inspires our employees to do their best work. We believe that the U.S healthcare system is in need of transformation, and we come to work each day dedicated to making that change a reality. At our core, we are guided by our company values:

Integrity

Our purpose guides our actions and gives us confidence in the path ahead. With unwavering honesty and dependability, we embrace the pressure of challenging the old and exemplify ethical leadership to create the new.

Courage

We face continuous challenges with grit and resilience. We embrace the discomfort of the unknown by balancing autonomy with empathy, and ownership with vulnerability. We boldly challenge the status quo to keep moving forward—always.

Together

The success of SmithRx reflects the strength of our partnerships and the commitment of our team. Our shared values bind us together and make us one. When one falls, we all fall; when one rises, we all rise.

Job Summary

As a Benefits Quality Assurance Analyst, you will be responsible for overseeing the core operations, processes, and quality standards of the benefits plan build and maintenance to ensure the delivery of a high quality SmithRx product.

Eligibility: Applicants must be based in one of the following states: Arkansas, Arizona, California, Colorado, Florida, Georgia, Kansas, Minnesota, Missouri, Nevada, North Carolina, South Carolina, Ohio, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin.

What will you do

  • Communicate project status and escalate issues for improved workflow efficiency
  • Collaborate with engineers on system enhancements to create workflow automation
  • Become subject matter expert on department standards and processes
  • Enhance test plans to ensure application functionality meets original requirements
  • Support business application systems and maintain plan data integrity
  • Maintain and capture department metrics, identify areas of opportunity for process improvement, and develop quality acceptance standards.
  • Identify quality improvement opportunities and present to Manager/Team Leaders for consideration and approval
  • Develops and deploys daily audits to assess the quality and accuracy of the Benefit Configuration Specialists/Analysts work products.
  • Ensures the quality and accurate analysis of benefit plan designs throughout their lifecycle, from pre-implementation to post-implementation in pharmacy or medical settings.

What you will bring

  • Bachelors degree or equivalent work experience in healthcare and/or PBM required
  • 4+ years of experience as a Pharmacy QA Analyst required
  • Comprehensive knowledge of benefits administration, benefits configuration, eligibility requirements, benefit provisions, and enrollment protocols required
  • Robust analytical skills; advanced skills in Microsoft Excel
  • Basic level skill and experience with MySQL preferred
  • 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 - you are a solutions-oriented problem solver and efficiency driven
  • Flexible, adaptable, and able to respond under the pressure of a fast-paced technology company

What SmithRx Offers You

  • Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insuran

Skills

Quality Assurance
Benefits Plan
Process Improvement
Data Analysis
Healthcare
PBM
Health-Tech

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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