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Lead, Benefits Testing
Lead, Benefits TestingSmithRx • Boston, MA, US
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Lead, Benefits Testing

Lead, Benefits Testing

SmithRx • Boston, MA, US
[job_card.30_days_ago]
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  • [job_card.full_time]
[job_card.job_description]

Lead, Benefits Testing

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 forwardalways.
  • 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 : As the Lead, Benefits Testing, you are responsible for managing, coaching, and developing a team of benefits testing specialists. You will ensure the quality and accuracy of benefit operations by overseeing comprehensive audits, testing, and documentation to drive the highest level of performance. This role will also be responsible for supporting the Plan Operations team with core quality assurance functions and best practices.

What you will do :

  • Manage team members in the delivery of benefit operations quality assurance, including testing and documentation, to 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 and provide appropriate levels of direction and support to your team members.
  • Develop and deploy daily audits to assess the quality and accuracy of the Benefit Configuration Specialists / Analysts work products.
  • Analyze audit results to identify trends, discrepancies, and areas for improvement.
  • Develop and implement quality improvement plans and corrective actions.
  • Provide leadership support to team members for escalations and complex configuration requests.
  • Communicate project status to leadership, escalating issues when appropriate, and drive changes to improve workflow efficiency.
  • Participate in initiatives to support process and workflow improvements and leverage new system capabilities.
  • Collaborate with engineers and benefit operations teams on system enhancements to create workflow automation and resolve issues.
  • Participate in the development and enhancement of quality assurance policies and procedures.

    • What you will bring to SmithRx :

  • 2+ years in a leadership role with direct reports, preferably leading people in a remote or hybrid setting.
  • 5+ years of working knowledge of claims processing, medical billing, healthcare benefits, and / or pharmacy benefits in a PBM or payer environment.
  • Strong analytical skills with the ability to interpret complex data sets and benefit plan designs.
  • Strong communication and interpersonal skills (via face-to-face meetings, conference calls, and written correspondence).
  • Excellent attention to detail and organizational skills.
  • Knowledge of industry regulations and standards.
  • Experience with Six Sigma or other quality improvement methodologies is preferred.
  • 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.

    • 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
  • 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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