SmithRx

QA Engineer

• 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.

Manager, Benefit Operations, Testing & QA

Account Manager

• Be accountable for Partner satisfaction and relationship
• Build trusting relationships with Partners’ operational leadership
• Maintain a comprehensive understanding of business and technical challenges faced by customers
• Apply cross-functional project management to drive resolution for escalated client issues, coordinating internal and external teams as necessary
• Identify product gaps by conducting business impact assessments and managing partner expectations
• Assess and prioritize issues that may lead to client attrition risk and ensure a strong mitigation plan is in place
• Coordinate additional customization, product development requests, or new product education with partners
• Troubleshoot and coordinate resolution of partner issues
• Leverage SmithRx resources with knowledge of our products to provide relevant adoption, best practices and technical recommendations on solutions and enhancements configured to meet customers’ business needs
• Have the ability to be a change agent and drive an initiative from concept to fruition. A strong focus on governance, driving adoption and recommending standardization where appropriate
• This individual will meet or speak with the Partner on a frequent cadence with the expectation of continually moving the relationship forward while uncovering new opportunities.
• Ability to work with internal and external cross-functional teams to drive projects to completion

Partner Relationship Manager

Operations

• Responsible for ensuring timely completion of non-electronically processed claims such as direct member reimbursement claims and commercial out-of-network claims.
• Ensure claims approvals and/or denials are made in accordance with company practices and procedures. Timely execution on member communications at scale, including mail-outs through our third-party mail vendor.
• Maintain reimbursement queue to meet the department's SLA’s. Completion of assigned claim cases in accordance with daily expectations.
• Sustain integrity of all existing claims processes by ensuring all process documentation is up to date.
• Participate in process improvement and quality assurance opportunities.
• Collaborate and provide cross-functional support to account management, member support, and other customer success teams.
• Act as a liaison between the clinical team and the member for denied reimbursements, initiating the prior authorization (PA) process to ensure proactive member support.
• Participate in internal meetings to help support initiatives and projects.
• Ability to prioritize and complete high-volume cases/claims.

Claims Operations Specialist

• Execute complex formulary coding within adjudication systems, ensuring clinical intent is accurately reflected in system logic.
• Utilize Advanced Excel and Google Sheets (VLOOKUP, Index/Match, Pivot Tables, and complex nested formulas) to manipulate large datasets.
• Apply deep knowledge of PBM hierarchies and adjudication logic to troubleshoot rejected claims and optimize system performance.
• Manage multiple high-priority projects simultaneously, shifting priorities fluidly to meet urgent client needs or business deadlines.

Formulary Operations Analyst

Manager

• Be the primary project contact during the integration process with external vendors and internal partners
• Lead integration meetings with vendors
• Identify the integration project requirements
• Ensure all requirements are documented in the standard project template
• Create and maintain a detailed project plan and open items log for project monitoring purposes
• Monitor and communicate integration project progress via client meetings and/or correspondence
• Engage and execute a testing plan to ensure the requirements were developed and working as designed
• Coordinate and collaborate across functional teams, and with the client to ensure items are completed timely, ensuring readiness for go-live
• Provide go-live support by assisting with escalated client issues, member issues, project issues, etc.
• Act as a mentor for colleagues throughout the integration process and solve for opportunities identified through trend analysis and process improvement

Integration Manager

Business Development Rep

• Own top-of-funnel sales motion for enterprise
• Create the BDR playbook for outbound prospecting
• Source new sales opportunities through outbound outreach and inbound qualification
• Grow top of funnel sales through warm and outbound prospecting campaigns
• Qualify with rigor: Run discovery to uncover current PBM challenges, member pain points, renewal timelines, and decision criteria; set high-quality meetings for AEs
• Personalized outreach at scale: Partner with marketing & Sales VPs to craft & execute outreach sequences, call talk tracks, and value-led messaging that map SmithRx’s transparent, pass-through PBM model to personalized buyer pain points
• Research companies and add prospects to our outbound lists
• Funnel/Pipeline hygiene & forecasting: Maintain meticulous CRM notes, activity logging, lead source attribution, conversion metrics, and next steps to provide visibility to the Go-To-Market team

Founding Business Development Representative

Pricing Analyst

• Conduct repricing and member experience analyses of prospect data
• Compose offers that large employers understand and find compelling
• Generate pricing and related answers to be entered into RFP platforms
• Collaborate with the Sales team to adapt and refine pricing offers to best suit the needs of prospects and enable SmithRx to win
• Generate client-ready spreadsheets and presentations that impress enterprise-grade clients
• Demonstrate an ability to learn quickly and to understand how SmithRx’s business model and approach is different from legacy PBMs in the industry
• Evaluate and assess risks associated with different pricing and RFP response strategies
• Collaborate with the Legal team to ensure that our pricing strategy is appropriately reflected in our contracting strategy
• Provide support in legal and contractual negotiations related to pricing and reconciliation terms

Pricing Strategy Director

Product Manager

• Define and drive the multi-year product roadmap for the SmithRx claims adjudication platform, identifying opportunities to enhance processing speed, automation, and transparency while maintaining a highly flexible, cloud-native architecture.
• Serve as an internal product Subject Matter Expert (SME) on NCPDP Telecommunication Standards (D.0 and beyond). Translate complex benefit designs, coordination of benefits (COB), and real-time pricing models into scalable, automated logic.
• Lead the full product lifecycle for adjudication features—from initial requirement gathering through engineering sprints and quality assurance—ensuring that new logic deployments do not disrupt high-volume, real-time transaction flows.
• Partner closely with Engineering, Data Science, Implementation and Operations teams to write detailed technical user stories, manage the adjudication platform backlog, and ensure the engine scales to support complex clinical rules and custom client configurations.
• Create, monitor and optimize key performance indicators (KPIs) related to claim success rates, latency, and financial accuracy. Develop robust testing frameworks to ensure that pricing logic and eligibility checks are 100% accurate at the point of sale.
• Collaborate with internal Operations and Clinical teams to streamline manual overrides, exception handling and other processes. Support engagement with external partners, such as switch vendors and PSAOs, to resolve routing issues and improve the pharmacy provider experience.
• Ensure the adjudication engine is built to support evolving industry requirements; prior experience working with EGWP guidelines, Medicare Part D compliance, or OIG/CMS reporting standards is a significant plus to ensure our platform remains competitive.

Senior Product Manager – Adjudication

Salesforce Administrator

• Manage advanced Salesforce configurations, security settings, and user roles.
• Lead the technical setup and maintenance of the Service Cloud environment, including routing, CTI integrations and Case Management to support a high-performing contact center.
• Oversee the end-to-end lifecycle of third-party integrations, from initial API setup and mapping to ongoing monitoring and troubleshooting of data sync issues.
• Design and implement scalable Salesforce solutions, including custom objects and advanced declarative automation.
• Work closely with Sales, Marketing, Account Management, Product/Engg, Customer Support teams and other teams to identify automation opportunities that improve efficiency.
• Assist with data governance, ensuring data integrity, deduplication and compliance.
• Develop advanced reports, dashboards, and analytics for actionable insights.
• Support release management, change management and deployment cycles.

Senior Salesforce Administrator

Recruitment

• Deliver an outstanding candidate experience from the very first interaction, ensuring every candidate leaves with a positive impression of SmithRx.
• Schedule onsite and virtual interviews by coordinating seamlessly with candidates, hiring managers, and interview teams.
• Build strong partnerships with recruiters and hiring teams by prioritizing clear communication, timely follow-up, and meticulous attention to detail.
• Identify and champion opportunities to improve the candidate experience and streamline recruiting workflows.
• Develop clear and achievable goals, metrics & KPIs in partnership with TA Ops and TA leaders
• Maintain process documentation and best practices to ensure alignment and consistency.
• Represent SmithRx’s employment brand with professionalism and care in every interaction.
• Experiment with new tools, processes, and best practices to improve scheduling operations and candidate experience.
• Assist and work closely with the TA Ops team to manage both long-term and ad-hoc strategic projects.
• Focus and drive compliance efforts. Ensure all we do is compliant. Looks for ways to make our processes more efficient and compliant.

Senior Talent Acquisition Coordinator

Formulary Operations Specialist

• Identifying and recruiting pharmacies to join the network. This involves conducting market research, negotiating contracts, and ensuring that the network includes a diverse range of pharmacy providers.
• Onboard new pharmacies to Smith network by screening incoming pharmacy applications for completeness of materials during credentialing process.
• Supporting contract management with pharmacy providers, including but not limited to reviewing performance metrics.
• Building and maintaining strong relationships with pharmacy providers, addressing their concerns or issues, and facilitating effective communication between the pharmacy and the organization.
• Resolving any issues or conflicts that arise between the organization and pharmacy providers. This may involve investigating complaints, conducting root cause analysis, and working collaboratively with internal teams and providers to find effective solutions.
• Collaborating with cross-functional teams, such as claims processing departments, to implement initiatives aimed at improving network efficiency, quality, and provider satisfaction.
• Create documentation for standard operating procedures within the Pharmacy Network.
• Recommend methods to improve processes used by the 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.

Pharmacy Network Provider Relations Manager

People Operations

• Be a trusted advisor, providing support from people leaders to individual contributors across the technology organization.
• Be a culture champion, and help infuse our company's values - Courage, Integrity, and Together - into everything we do, ensuring remote and distributed teams feel connected to the mission of disrupting a broken industry.
• Coach and influence managers on how to build and manage an amazing team.
• Provide business leaders with data, findings, and recommendations of their organizations’ "health" by assessing trends in performance, engagement, retention risk and burnout prevention.
• Partner with business leaders by providing strategic guidance on talent management, workforce planning and organizational design.
• Provide day-to-day employee performance management guidance to leaders (e.g., coaching, counseling, career development, disciplinary actions).
• Collaborate with other People functions (Talent Acquisition, People Operations and Learning & Organizational Development) in the design and implementation of People programs to attract, retain, and promote a culture of high performance.
• Facilitate the adoption and education of HR policies and practices within the company.
• Build credibility and trust among employees; resolve employee concerns with compassion and follow-through.
• Regularly handle critical, highly sensitive and confidential employee relations matters.

People Partner, Technology

Financial Planning and Analysis

• Own the Long Range Plan, aligning capital allocation and growth assumptions with the company’s long-term vision.
• Build and maintain models to measure and improve unit economics across customers, customer segments, cohorts and channels.
• Deliver clear, executive-ready materials for monthly reviews and board discussions that distill data into clear and actional narratives.
• Serve as a key support lead for future fundraising efforts and other strategic projects and initiatives.
• Partner with cross functional leaders on scenario modeling and business case development, connecting financial discipline to operational outcomes.
• Define and track KPIs and leading indicators of business performance to drive operational improvements.
• Contribute to development of differentiated forecasting features or tools for the company and clients.
• Partner with GTM teams on pricing strategy and proposals.
• Stand up the systems, tooling, and frameworks the Strategic Finance team needs to influence the business, including automation, reporting, and operational rhythms.
• Partner closely with the FP&A team to ensure near-term budgets and forecasts are tightly aligned with long-term forecasting.

Senior Strategic Finance Manager

Compliance

• Research compliance program benchmarks, maturity measures, and other requirements
• Design and/or enhance organizational code of conduct
• Write, edit, or maintain compliance policies, procedures, and program descriptions
• Construct specific and effective compliance training and education
• Establish and enforce timely reviews of business owned policies and procedures
• Create and manage policy & procedure workgroup initiatives
• Assist with compliance vendor oversight activities
• Create compliance communication plans that increase workforce engagement
• Write and track compliance program responses to client requests for proposal/information (RFP/RFI), questionnaires, and other attestations
• Develop job aids, playbook, and other program documentation
• Build and maintain positive and strategic relationships with internal and external stakeholders
• Support our compliant and ethical culture
• Assist in developing or updating oversight materials and reporting metrics
• Abide by organization retention standards and version controls
• Investigate potential or reported issues of non-compliance
• Perform root-cause analysis and identify prevention, detection, and correction opportunities
• Ensure business partners complete corrective actions in a timely and effective manner
• Monitor organizational disciplinary actions and incentives for consistency, accuracy, and timeliness
• Collaborate with Legal and other stakeholders to interpret regulations
• Other responsibilities as assigned