$70K - 100K a year
Oversee benefits plan operations and quality, collaborate on system enhancements, develop audits, and maintain data integrity for pharmacy or medical benefit plans.
Bachelor's or equivalent healthcare experience, 4+ years as Pharmacy QA Analyst preferred, comprehensive benefits knowledge, strong Excel and communication skills, and ability to work in a fast-paced environment.
Description: • Oversee core operations, processes, and quality standards of the benefits plan build and maintenance to ensure delivery of a high quality SmithRx product • 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 • Ensure the quality and accurate analysis of benefit plan designs throughout their lifecycle, from pre-implementation to post-implementation in pharmacy or medical settings Requirements: • 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 - solutions-oriented problem solver and efficiency driven • Flexible, adaptable, and able to respond under the pressure of a fast-paced technology company • 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 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
This job posting was last updated on 9/14/2025