Benefits Configuration Analyst

Location Guidelines: United States · Workplace: 🌐 Remote

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.

As a 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.

Work with clients, identifying and understanding benefit plan requirements. Build and maintain pharmacy benefit plans for client groups.

Aid in the organization of benefit configuration and structure for the accounts assigned by monitoring plan data integrity.

Assist in determining process improvement efforts.

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. Provide insight into 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.

Support new client implementations, conduct go-live testing, perform post go-live auditing and support to ensure plans are configured to confirm accuracy.

4+ years of experience in payer/claims and benefit configuration required

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, dependable, adaptable, and able to respond under the pressure of a fast-paced technology company

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

Metro New York City - Connecticut, New Jersey, New York and Pennsylvania

Metro District of Columbia - District of Columbia, Maryland, Virginia and West Virginia

Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Wisconsin, Wyoming

Non metro Colorado, Connecticut, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Texas, Virginia, Washington, and West Virginia

Base Salary: The range listed above reflects our standard pay scale and actual pay will vary based on work location, job level, job-related knowledge, skills, and experience.

Total Rewards: In addition to base pay, this role may be eligible for bonuses, commissions, or equity. SmithRx offers a variety of benefits to help you live well, including: time off programs, medical, dental, vision, mental health support, paid parental leave, life and disability insurance and 401(k).

Individual offers are tailored to your geography, experience, skills, and education. Your recruiter can share more specific details during the hiring process. In the meantime, feel free to explore our comprehensive benefits here.

Originally posted on Himalayas

How to Apply: Click "Apply for this Job" to be redirected directly to SmithRx's official application form.