Senior Benefits Configuration Analyst

Remote

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Health-Tech, Pharmacy Benefit ManagementIndustries

Requirements

Candidates must possess a Bachelor's degree or equivalent work experience in healthcare and/or PBM, with at least 6 years of experience in benefits configuration within a healthcare or health insurance organization. Strong analytical skills, advanced Microsoft Excel proficiency, and excellent communication abilities are required, along with a self-starter mentality and a solutions-oriented, execution-focused ethos.

Responsibilities

The Senior Benefits Configuration Analyst will support cross-functional teams during implementations and manage pharmacy benefit plans on various platforms, ensuring product quality. Responsibilities include understanding client benefit plan requirements, building and maintaining benefit configurations, monitoring plan data integrity, and spearheading process improvements. The role also involves creating and maintaining prior authorizations and step therapy rules, transitioning clients, updating formularies, communicating project status, resolving benefit-related inquiries, providing troubleshooting support for claims adjudication, collaborating with engineers on system enhancements, interfacing with external vendors, and supporting new client implementations with testing and post-go-live auditing.

Skills

Benefits Configuration

Pharmacy Benefit Management (PBM)

Health-Tech

Drug Acquisition Platform

Implementation Support

Platform 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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