Benefits Configuration Analyst

Summary

Join SmithRx, a rapidly growing Health-Tech company, as a Benefits Configuration Analyst. You will support cross-functional teams during implementations, build and manage pharmacy benefit plans on various platforms, and ensure a high-quality product. This role involves supporting the Plan Operations team, building and maintaining accurate benefit configuration, and working with clients to understand their benefit plan requirements. You will also aid in process improvement, maintain authorizations and rules, and collaborate with other teams to resolve inquiries. The position requires 4+ years of experience in payer/claims and benefit configuration, strong analytical and communication skills, and a self-starter mentality. SmithRx offers competitive benefits, including health insurance, retirement plans, paid time off, and professional development opportunities.

Requirements

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

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

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
• 12 Paid Holidays
• Wellness Benefits
• Commuter Benefits
• Paid Parental Leave benefits
• Employee Assistance Program (EAP)
• Well-stocked kitchen in office locations
• Professional development and training opportunities