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Pricing and Reconciliation Manager

SmithRx

SmithRx

Plano, TX, USA
Posted on Friday, January 19, 2024

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 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: Do the right thing. Especially when it’s hard.
  • Courage: Embrace the challenge.
  • Together: Build bridges and lift up your colleagues.

Job Summary:

We are looking to add a Pricing and Reconciliation Manager to the team who will be responsible for helping SmithRx set RFP pricing and helping spearhead our reconciliation process with clients and third parties. This person will collaborate closely with our Sales, Strategy, Legal, and Revenue teams to ensure that SmithRx continues to win new business with an appropriate level of risk.

The successful candidate will be commercially-minded and comfortable with AWP discount and rebate guarantee pricing as commonly submitted in PBM RFPs run by brokers and pharmacy consultants

What you will do:

Prescription Drug RFP Pricing:

  • Set AWP discount and rebate guarantee pricing for SmithRx responses to pharmacy consultant RFP questionnaires
  • Identify trends, patterns, and outliers in drug pricing data that impact pricing decisions
  • Stay informed about industry trends, regulatory changes, and market dynamics that may impact prescription drug pricing
  • 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 strategies
  • Develop playbooks for broker and pharmacy consultant partners that require custom RFP responses and structures
  • Collaborate with the Legal team to ensure compliance with regulatory requirements, contractual obligations, and industry standards
  • Provide support in legal and contractual negotiations related to pricing and reconciliation terms

Reconciliation and Risk Management:

  • Manage external reconciliation processes with clients, pharmacy consultants, and other stakeholders ensuring accuracy and alignment with contractual agreements
  • Communicate reconciliation findings to relevant stakeholders in a clear and concise manner, including regular updates on risk assessments and mitigation strategies
  • Collaborate with external partners to resolve discrepancies, implement corrective actions, and maintain positive working relationships
  • Operationalize the measurement and tracking of risk across SmithRx’s book of business in cooperation with the Revenue, Sales, Strategy, and Legal teams
  • Generate reports and analyses on SmithRx’s reconciliation performance to support future pricing decision-making

What you will bring to SmithRx:

  • Bachelor’s degree with 7+ years of experience working with pharmacy benefits contracts, AWP discount pricing and rebate guarantees
  • Experience working with historical claims data to assess and manage risk
  • Experience with leading conversations with brokers and pharmacy benefits consultants
  • Experience with Excel is required
  • You have a proven track record of delivering exceptional, quantifiable business impact
  • You have experience in a highly strategic, analytical and operational role in fast-paced environments
  • You are low ego and have a knack for working well with a wide range of people
  • You excel in using data to reach decisions and are comfortable demonstrating these skills to external stakeholders

Bonus points:

  • Experience leveraging Salesforce, Box, Google Suite, and other technology tools to drive operational efficiencies
  • Finance, pharmacy consulting, start-up or investment banking experience
  • Experience running or reviewing large volumes of pharmacy benefit manager RFPs

What SmithRx Offers You:

  • Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance
  • Flexible Spending Benefits
  • 401(k) Retirement Savings Program
  • Short-term and long-term disability
  • Discretionary Time Off
  • 12 Paid Holidays
  • Commuter Benefits
  • Paid Parental Leave benefits
  • Employee Assistance Program (EAP)
  • Well stocked kitchen in office locations
  • Professional development and training opportunities