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.
What will you do:
- Organize testing suites, create test plans, and submit moderately difficult test cases to validate the accuracy of complex benefit configuration setups.
- Serve as a key liaison with senior members of the Benefit Operations team, actively communicating to resolve configuration discrepancies, clarify plan designs, and report actionable insights back to the testing team.
- Provide support, guidance, and peer review for junior team members to ensure testing accuracy, helping them understand SmithRx claims adjudication systems and upstream/downstream processes.
- Handle Advanced Logic Validation such as Clinical/Prior Authorization and Financial Accumulators. Ensuring patient out-of-pocket maximums and cost-shares remain accurate.
- Document detailed defect reports for issues uncovered during testing and assist in the development of process improvements focusing on efficiency and accuracy.
What will you bring to SmithRx:
- Minimum of 2 - 4 years of related experience in benefits configuration or testing in healthcare. PBM or managed care experience is preferred but not required.
- Associate degree or equivalent work experience is required.
- Strong understanding of benefit design standards, including HIPAA, NCPDP, and SmithRx internal business standards, alongside moderate skills in Microsoft Excel.
- Ability to work with little instruction on daily work, relying on general instructions only for newly introduced assignments.
- Strong critical thinking skills, such as analyzing data, drawing logical conclusions, and applying smart solutions to moderately difficult situations.
- Communicate effectively (written, verbal/presentation, and active listening) to successfully act as a liaison and collaborate cross-functionally.