Benefits Configuration Specialist

Benefits Configuration Specialist

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.

Key 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.

Required Qualifications & Experience:

• 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. 

Preferred Qualifications & Experience:

• Pharmacy Technician experience

Work Environment: Remote

Benefits And Perks

Subject to program eligibility, this position qualifies for a robust suite of benefits including: Paid Time Off, a 401(k) program, Health Insurance including Dental & Vision coverage, Student Loan Reimbursement, Health Savings Account, and an Employee Assistance Program.

EmpiRx Health is an Equal Opportunity Employer 

At EmpiRx Health, we wholeheartedly embrace the power of diversity and the magic of inclusion. The kaleidoscope of unique perspectives, backgrounds, and talents fuels our innovation and sets us apart. We're on a mission to build a team as diverse as the world we serve, where everyone is welcome and celebrated. We're not just breaking down barriers; we're actively erasing them to create an environment where opportunity knows no bounds. In unity, we find our strength and invite individuals from all walks of life to join us in our exhilarating journey to shape a brighter, more inclusive future together.

Note: This job description is a general outline of responsibilities and qualifications for the role. Additional duties may be assigned, and the position may evolve to meet the organization's needs