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Pharmacy Network Pricing Analyst

Remote

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: Our purpose guides our actions and gives us confidence in the path ahead. With unwavering honesty and dependability, we embrace the pressure of challenging the old and exemplify ethical leadership to create the new.
  • Courage: We face continuous challenges with grit and resilience. We embrace the discomfort of the unknown by balancing autonomy with empathy, and ownership with vulnerability. We boldly challenge the status quo to keep moving forward—always.
  • Together: The success of SmithRx reflects the strength of our partnerships and the commitment of our team. Our shared values bind us together and make us one. When one falls, we all fall; when one rises, we all rise.

Job Summary:

The Pharmacy Network Pricing Analyst plays a critical role in reimbursement price modeling and Maximum Allowable Cost (MAC) pricing strategy. This role is responsible for the analysis, modeling, and administration of pharmacy reimbursement rates to maintain competitive positioning, maximize profitability, and ensure contractual compliance. The ideal candidate will have a strong analytical foundation (utilizing Snowflake/SQL), deep understanding of pharmacy claims data, and experience with various pricing models (e.g., AWP, WAC, MAC, NADAC).

What you will do:

   Strategic Modeling & Optimization

  • Develop and maintain complex MAC models and processes to support reimbursement strategy.
  • Execute, implement, and optimize current and future network and pricing innovations.
  • Ensure all pricing strategies adhere to contractual agreements while maximizing profitability and driving cost savings.
  • Develop capabilities specifically targeted to achieve the efficient and effective application of the company’s products and services.

   Network Administration & Compliance

  • Provide assistance and coordination to the Pharmacy Network team in weekly process tasks.
  • Run weekly automated pricing tasks to ensure process accuracy and implementation.
  • Gather input data for weekly processes from pricing resources and pharmaceutical data sources.
  • Collaborate with the legal team to ensure strict compliance with MAC appeals and state reimbursement regulations.
  • Create detailed procedural documentation covering all automation and analytical tasks for audit and compliance needs.

   Analytics & Reporting

  • Perform pharmacy analytics reporting and modeling related to MAC Management.
  • Develop, maintain, and distribute ad-hoc reports and financial models as needed.
  • Support the pharmacy pricing appeals process, including receiving/sending communications and compiling necessary data for automated processes.
  • Work with key stakeholders to create automation around core business processes.
  • Contribute to ongoing financial reporting efforts.

Technical Skills

  • Expert proficiency in SQL or other data querying and manipulation tools.
  • Experience with large claims datasets and data warehouse environments.
  • Proficiency in business intelligence tools (specifically Looker) for data visualization and reporting.
  • Proficient user or understanding of query languages/platforms that assist in day-to-day automation and procedures (Examples may include Microsoft Suite, SQL, Snowflake, and Looker).

What you will bring to SmithRx:

  • Experience: Bachelor’s Degree OR 3-5 years of relevant experience in a financial analysis, pricing, or network management role within the PBM, health plan, or pharmacy industry.
  • Analytical Acumen: Strong mathematical, statistical, computer science, or economic acumen to assist in overall financial brand and generic pricing management.
  • Core Competencies: Strong analytical, detail-oriented, and problem-solving skills.
  • Organizational Skills: Ability to organize and manage multiple priority tasks simultaneously.
  • Problem Solving: Demonstrated ability to apply critical thinking and problem-solving skills in unstructured situations.
  • Data Management: Strong background in financial reporting and data management best practices.

What SmithRx Offers You: 

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

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