SmithRx is a tech-forward PBM committed to changing the way pharmacy benefits are managed.
Pharmacy Benefits QA Analyst
Location
United States
Posted
14 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
Pharmacy Benefits QA Analyst
SmithRx
Role Description 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. 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 - Develop and deploy daily audits to assess the quality and accuracy of the Benefit Configuration Specialists/Analysts work products - Ensure the quality and accurate analysis of benefit plan designs throughout their lifecycle, from pre-implementation to post-implementation in pharmacy or medical settings Qualifications - 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 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
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