Benefits Configuration Specialist
About The Position
EmpiRx Health is the leading clinically-driven pharmacy benefits management company. As the pioneer in value-based pharmacy care, EmpiRx Health puts its customers and members first by enabling them to take control of their pharmacy benefits, healthcare outcomes, and financial results. We place more emphasis on member care than any other PBM by focusing on health outcomes first. Our pharmacists and clinicians are at the center of everything we do―and our population health solution delivers tailored strategies for our clients. Leveraging our newly launched, AI-powered pharmacy care platform, Clinically™, EmpiRx Health’s pharmacists and client experience teams provide the highest quality pharmacy care to our clients and their members. This enables benefits plan sponsors to keep their members healthy, happy, and productive, while substantially reducing prescription drug spending, which has been on an explosive growth trajectory in recent years. EmpiRx Health is in unprecedented growth, and we're seeking a highly skilled and experienced Benefits Configuration Specialist. In this critical role, you will ensure our clients are set up with their prescription benefit plan details correctly in our systems to enable seamless implementation of their plan design. You will contribute to operational accuracy, client satisfaction, and compliance by supporting configuration, documentation, and validation of benefit designs.
Requirements
- Bachelor’s degree or other a relevant experience as determined by the company
- 5 years benefit configuration experience within a PBM or Healthplan.
- Plan setup testing
- Excellent attention to detail and strong communication.
Nice To Haves
- Pharmacy Technician experience
Responsibilities
- Understanding client’s intent for the setup of their benefit plans.
- Completing configuration of new clients and maintaining changes for existing clients, including but not limited to; account structure, benefit plan design, clinical program, drug coverage, network and billing.
- Identifying all test cases scenarios that will be used to confirm the setup of the plan is accurate.
- Auditing all configuration elements to ensure accuracy and meets the client’s intent.
- Developing and maintaining a continuous improvement approach to confirm processes and internal controls are in place and updated to meet industry, business, and technology standards.
- Assisting internal team with claim inquiries and training.
- Creating and maintaining training documentations.
- Adjusting our process to support internal teams.
Benefits
- Paid Time Off
- a 401(k) program
- Health Insurance including Dental & Vision coverage
- Student Loan Reimbursement
- Health Savings Account
- an Employee Assistance Program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
