SmithRx is a tech-forward PBM committed to changing the way pharmacy benefits are managed.
Benefits Configuration Analyst
Location
United States
Posted
2 days ago
Salary
0
Seniority
Senior
Job Description
Benefits Configuration Analyst
SmithRx
• 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.
Job Requirements
- 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, Life insurance
- Flexible Spending Benefits
- Discretionary Time Off
- 401(k) Retirement Savings Program
- Paid Parental Leave benefits
- Professional development and training opportunities
Related Guides
Related Categories
Related Job Pages
More Analyst Jobs
• Conduct document review and open-source research in Ukrainian and English to determine compliance, anti-bribery, anti-corruption and sanctions related issues. • Use DDIQ and open-source research to identify risk-relevant information and determine its importance to the client. • Use databases of shipping records to conduct supply chain risk assessments • Assess the accuracy of information collected by Exiger’s artificial intelligence document review platform. • Write clear, concise and thoroughly researched documentation for clients. • Onboard new users and brief them on all the capabilities we can provide. • Advise your customers on how best to utilize the software and tools they’ve purchased. • Train client users on Exiger systems.
• Estamos buscando **Analista Funcional** con experiencia en tecnología para sumarse a nuestro equipo en un proyecto para importante empresa estatal en Uruguay. • Este rol requiere una fuerte capacidad técnica y la habilidad para trabajar en un entorno ágil y dinámico. • La modalidad de trabajo es **Remoto**, con disponibilidad para reuniones presenciales en las oficinas de Montevideo.
• Configuring, modifying, testing, and maintaining Epic & other Clinical applications • Building collaborative relationships with hospital leadership, clinical department users, technology, and corporate departments • Providing second-tier support to end users for reliable application system availability and performance • Designing, verifying, documenting, amending, and refactoring complex software configurations • Developing and executing test plans and test cases • Investigating and resolving application-related issues • Prioritizing and diagnosing incidents and documenting resolutions • Participating in an after-hours on-call rotation
Role Description This Credentialing Analyst position is a fully Remote opportunity! Schedule is full time, 1.0 FTE, Day shift, Monday-Friday, 8am-4:30pm in Alaska time zone, with some flexibility and advance notice to provide support outside these hours; 40 hours per week. - The Credentialing Analyst is responsible for the comprehensive coordination, analysis, and execution of practitioner credentialing and privileging activities for the Alaska Region Medical Staff. - This role applies critical thinking and regulatory expertise to ensure accurate primary source verification and compliance with medical staff bylaws, organizational policies, and accreditation standards. - The Credentialing Analyst evaluates practitioner data to ensure all governance thresholds and eligibility criteria are met prior to committee review. - Identifies discrepancies and prepares detailed credentialing files and action summaries to support informed decision-making. - This position maintains data integrity within credentialing systems, monitors timelines and reporting requirements, and serves as a subject matter resource to medical staff leadership to ensure consistent, compliant credentialing operations. Qualifications - Bachelor's Degree or 3 years of medical staff credentialing experience, including complex privilege review will be considered. - Within 2 years of hire: Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM). - 2 years of Medical Staff credentialing experience. - 2 years of experience with primary source verification, privileging review, and committee file preparation. Requirements - MD staff experience (preferred). Benefits - Comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching. - Health care benefits (medical, dental, vision). - Life insurance and disability insurance. - Time off benefits (paid parental leave, vacations, holidays, health issues). - Voluntary benefits and well-being resources.




