Senior Benefits Configuration Analyst

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 on 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

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.

As a Senior Benefits Configuration Analyst, you will support cross-functional teams during implementations and build and manage pharmacy benefit plans on various platforms to ensure a high quality SmithRx product. This role will also be responsible for supporting the Plan Operations team with core benefits operations functions while building and maintaining accurate benefit configuration.

What You Will Do

• 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 the accounts assigned by monitoring plan data integrity.
• Spearhead process improvement efforts.
• Provide support to team members for escalations and complex configuration requests.
• Create and maintain prior authorizations and step therapy rules.
• Grandfather/transition new clients and update formularies with changes at the direction of the clinical team.
• Communicate project status, escalating issues when appropriate.
• Drive changes to improve workflow efficiency.
• Collaborate with member support and customer success teams to review and resolve inquiries related to benefits timely to improve member experience.
• Provide troubleshooting support for our claims adjudication process.
• Collaborate with engineers on system enhancements to drive automation.
• Interface with external vendors surfacing issues and tracking outstanding work requests.
• Support new client implementations, conduct go-live testing, perform post go-live auditing and support to ensure plans are configured to confirm accuracy.

What You Will Bring to SmithRx

• Bachelor's degree or equivalent work experience in healthcare and/or PBM required.
• 6+ years of experience in benefits configuration with a healthcare or health insurance organization required.
• Robust analytical skills.
• Advanced skills in Microsoft Excel.
• 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