Manager – Pharmacy Claims Operations
Posted on 10/31/2023

201-500 employees

Transparent pharmacy benefits manager reducing drug costs
Company Overview
SmithRx is a transparent pharmacy benefits manager that prioritizes customer alignment, demonstrated by its independence from insurance companies and pharmacies. The company's culture is centered on exceptional customer service, as evidenced by testimonials highlighting the staff's proactive assistance in reducing medication costs and ensuring timely delivery. With its advanced technology and cost-saving programs, SmithRx has positioned itself as an industry leader in providing affordable pharmacy benefits to employers and patients.
Data & Analytics

Company Stage

Series B

Total Funding





San Francisco, California

Growth & Insights

6 month growth


1 year growth


2 year growth

Remote in USA • Plano, TX, USA • Lehi, UT, USA
Experience Level
Desired Skills
Medical, Clinical & Veterinary
Operations & Logistics
  • 5+ years in in a leadership role with direct reports required. Preferably leading people working in a remote setting
  • 8+ years of working knowledge of claims processing, medical billing, healthcare benefits, and/or pharmacy benefits
  • Bachelors or equivalent work experience required
  • Experience with document management practices is preferred
  • Executive-level communication and interpersonal skills, with the ability to effectively navigate and mediate conflict and foster honest dialogue
  • Ability to navigate unique and individual team member scenarios while providing coaching through the day-to-day challenges, and mentoring through a long-term relationship- based approach to drive linger term individual success
  • Ability to take initiative with little to no direction
  • Passion for operational excellence that directly impacts clients, partners and end users
  • Passion for building excellence and constantly iterating on process improvements
  • Passion for developing, inspiring, and leading teams composed of less-experienced employees
  • Execution-focused ethos - you are a solutions-oriented problem solver and efficiency-driven
  • Organized and thoughtful with the ability to handle competing issues and prioritize accordingly
  • Comfortable with leading teams in a fast-changing environment
  • Flexible, adaptable, and able to respond under the pressure of a fast-paced organization
  • Establish clear team goals/priorities in alignment with the broader Plan Operations and Customer Success strategy
  • Manage the achievement of team and department objectives and key results
  • Perform regular team member coaching and identify team training opportunities
  • Actively participate in the full interview and onboarding life cycle for new hires
  • Identify process gaps and lead process improvement efforts for the claim operations team
  • Ensure claims approvals and/or denials are made in accordance with company practices and procedures
  • Timely execution of mailed member communications
  • Oversees claim file review and analysis to support member disruption
  • Support new group implementation activities related to claims management
  • Be accountable for ensuring timely completion of non-electronic pharmacy claims for direct member reimbursement