Note: The job is a remote job and is open to candidates in USA. SmithRx is a rapidly growing Health-Tech company focused on transforming the pharmacy benefit management sector through technology and cost-saving tools. The Benefits Configuration Analyst will build and manage pharmacy benefit plans, support client implementations and Plan Operations, and ensure accurate benefit configuration. The role also involves maintaining clinical benefit rules, troubleshooting claims adjudication, and collaborating with internal teams to resolve benefit-related inquiries.
Responsibilities
- 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
Skills
- 4+ years of experience in payer/claims and benefit configuration required
- Analytical skills; Microsoft Excel skills
- 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
Benefits
- Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance
- Flexible Spending Benefits
- 401(k) Retirement Savings Program
- Short-term and long-term disability
- Discretionary Paid Time Off
- Paid Company Holidays
- Wellness Benefits
- Commuter Benefits
- Paid Parental Leave benefits
- Employee Assistance Program (EAP)
- Well-stocked kitchen in office locations
- Professional development and training opportunities
- This role may be eligible for bonuses, commissions, or equity
- Mental health support
Company Overview