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Pharmacy Benefits QA Analyst

Pharmacy Benefits QA Analyst

SmithRxPlano, TX, US
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Job Description

Job Description

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 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.

Job Summary :

As a Benefits Quality Assurance Analyst, you will be responsible for overseeing the core operations, processes, and quality standards of the benefits plan build and maintenance to ensure the delivery of a high quality SmithRx product.

In order to be eligible for this position 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.

What will you do :

  • Communicate project status and escalate issues for improved workflow efficiency
  • Collaborate with engineers on system enhancements to create workflow automation
  • Become subject matter expert on department standards and processes
  • Enhance test plans to ensure application functionality meets original requirements
  • Support business application systems and maintain plan data integrity
  • Maintain and capture department metrics, identify areas of opportunity for process improvement, and develop quality acceptance standards.
  • Identify quality improvement opportunities and present to Manager / Team Leaders for consideration and approval
  • Develops and deploys daily audits to assess the quality and accuracy of the Benefit Configuration Specialists / Analysts work products.
  • Ensures the quality and accurate analysis of benefit plan designs throughout their lifecycle, from pre-implementation to post-implementation in pharmacy or medical settings.

    • What you will bring :

  • Bachelors degree or equivalent work experience in healthcare and / or PBM required
  • 4+ years of experience as a Pharmacy QA Analyst preferred
  • Comprehensive knowledge of benefits administration, benefits configuration, eligibility requirements, benefit provisions, and enrollment protocols 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 problem solver and efficiency driven
  • Flexible, adaptable, and able to respond under the pressure of a fast-paced technology company

    • What SmithRx Offers You :

  • 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
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