Pharmacy Network Provider Relations Associate
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. 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 of:
- Do the right thing. Especially when it’s hard.
- Embrace the challenge.
- Build bridges and lift up your colleagues.
The Pharmacy Network Provider Relations Associate will be responsible for supporting the Pharmacy Network Team by carrying out day-to-day departmental tasks, onboarding new pharmacies, and supporting and assisting pharmacies. You will work closely with valued pharmacy partners and internal cross-functional teams across SmithRx organization. You will be a key contributor to sustaining high pharmacy satisfaction, retention and our reputation for excellence.
What you will do:
- Onboard new pharmacies to Smith network by screening incoming pharmacy review for completeness of materials during credentialing process
- Assist with setting up pharmacy network structure in adjudication platform and test cases to implement the change
- Support the efforts of all cross functional teams/departments
- Audit contract loads for adherence to quality measures and reporting standards
- Create documentation for standard operating procedures within the Pharmacy Network
- Provide external and internal support on pharmacy claim investigations
- Audit work to identify and process / coordinate correction of loading errors
- Recommend methods to improve processes used by department
- Build and maintain a database of pharmacy partners to ensure information is accurate and up to date
- Escalate pharmacy concerns internally and to help solve complex issues
- Assist with building out a Knowledge Base and contribute to our ongoing process improvement efforts
What you will bring to SmithRx:
- 4+ years of experience in managed care or PBM experience (experience can include credentialing providers, provider relations, provider administration), working with pharmacy adjudication platforms
- Highschool diploma/GED
- Intermediate level of proficiency in MS Excel (formulas, macros, pivot tables, etc.)
- Strong networking, interpersonal and relationship-building skills
- Strong teamwork skills, focused on developing high-performing team
- Knowledge of pharmacy pricing aspects
- Knowledge of Provider networks and/or affiliations
- Ability to work in a fast-paced and high-functioning environment and meet deadlines while managing multiple high priorities.
- Ability to work independently with minimal supervision.
- Pharmacy Technician Certification preferred, healthcare experience required.
- Self-driven and motivated with a desire to succeed in a fast-paced, changing environment