Manager, Benefit Operations Testing & QA

Posted 15 Days Ago
Hiring Remotely in USA
Remote
Senior level
Pharmaceutical
The Role
The Manager of Benefit Operations Testing & QA leads a team responsible for benefit configuration and management, ensuring high-quality delivery and process improvement in pharmacy benefits operations.
Summary Generated by Built In

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:
The Manager, Benefit Operations Testing & QA is responsible for leading, coaching, and developing a team of benefit configuration specialists. You will ensure the high-quality delivery of the SmithRx product by overseeing the build and management of pharmacy benefit plans on various platforms. This role is a key part of the Plan Operations team, responsible for core benefits operations functions, process improvement, and upholding best practices in benefit configuration.

In order to be eligible for this position applicants must be based in one of the following states: Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Indiana, Kansas, Kentucky, Massachusetts, Minnesota, Missouri, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin.

What you will do:

  • Manage team members in the delivery of benefit configuration, testing, and documentation aspects of the plan build and maintenance responsibilities to drive the highest level of performance and meet or exceed service level agreements.
  • Manage employee performance through defined employee scorecards and performance metrics.
  • Provide ongoing feedback and coaching to ensure performance targets are met, providing appropriate levels of direction and support to your team members as needed.
  • Schedule employees, track productivity, maintain work schedules, coordinate different activities, and approve time off and overtime.
  • Participate in initiatives to support process/workflow improvements, leverage new system capabilities within work processes, and consistently institute best practices within the function.
  • Work with clients, identifying and understanding benefit plan requirements. Build and maintain pharmacy benefit plans for client groups.
  • Own all aspects of benefit configuration organization and structure for accounts by monitoring plan data integrity.
  • Provide leadership support to team members for escalations and complex configuration requests.
  • Communicate to leadership on project status, escalating issues when appropriate, and drive changes to improve workflow efficiency.
  • Be accountable for ensuring review and resolution of inquiries from internal teams such as member support and customer success are completed timely to improve member experience.

What you will bring to SmithRx:

  • 5+ years in a leadership role with direct reports required, preferably leading people working in a remote setting.
  • 8+ years of working knowledge of pharmacy benefits, benefit configuration, healthcare benefits, and/or claims processing.
  • Experience with document management practices is preferred.
  • Executive-level communication and interpersonal skills, with the ability to effectively navigate and mediate conflict and foster honest dialogue.
  • Ability to navigate unique and individual team member scenarios while providing coaching through day-to-day challenges and mentoring through a long-term, relationship-based approach to drive long-term individual success.
  • Ability to take initiative with little to no direction.
  • Passion for operational excellence that directly impacts clients, partners, and end-users.
  • Passion for building excellence and constantly iterating on process improvements.
  • Passion for developing, inspiring, and leading teams composed of less-experienced employees.
  • Execution-focused ethos - you are a solutions-oriented problem solver and efficiency-driven.
  • Organized and thoughtful with the ability to handle competing issues and prioritize accordingly.
  • Comfortable with leading teams in a fast-changing environment.
  • Flexible, adaptable, and able to respond under the pressure of a fast-paced organization.
  • Bachelor's degree or equivalent work experience required.

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 
  • Paid Company Holidays
  • Wellness Benefits
  • Commuter Benefits 
  • Paid Parental Leave benefits
  • Employee Assistance Program (EAP)
  • Well-stocked kitchen in office locations
  • Professional development and training opportunities

Top Skills

Document Management
Pharmacy Benefit Management
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The Company
San Francisco, CA
46 Employees
Year Founded: 2016

What We Do

SmithRx is committed to providing a straightforward approach to reducing drug costs and improving health outcomes. We understand that reducing pharmacy costs is top of mind for us all. We utilize cloud technologies to deliver the most streamlined and cost-effective PBM solution: one that is modularized and can be tailored to meet individual needs. Our compelling value proposition can be summarized simply as follows: - 100% Pass-through Pricing & Lowest Total Costs - The Most Advanced Cloud PBM - Best Health Outcomes

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