Pharmacy Network Pricing Analyst

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:

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

Job Summary:

The Pharmacy Network Pricing Analyst plays a critical role in analyzing and managing pricing strategies within the pharmacy network of a healthcare or insurance organization. They are responsible for conducting pricing analysis, modeling Maximum Allowable Cost (MAC), developing pricing strategies, and supporting contract negotiations. They collaborate with cross-functional teams, perform market research, and monitor financial performance to optimize profitability. Their duties include modeling pricing scenarios, ensuring pricing compliance, and communicating pricing strategies to stakeholders. The Pricing Analyst also contributes to process improvement initiatives and maintains pricing databases and reports. Overall, this role requires strong analytical skills, market research expertise, and the ability to effectively collaborate with internal teams and external providers.

What will you do:

• Assisting in contract negotiations with pharmacy providers and participating in pricing discussions. This involves analyzing contract proposals, evaluating pricing terms, and providing insights to ensure pricing agreements are favorable and aligned with organizational goals.
• Conducting analysis of pharmacy network pricing structures, fee schedules, reimbursement rates, and related financial data. This includes assessing the current pricing models, evaluating profitability, identifying cost drivers, and determining opportunities for improvement.
• Researching and monitoring market trends, competitive pricing strategies, and regulatory changes that impact pharmacy network pricing. This helps to inform pricing decisions and ensure competitive positioning in the market.
• Developing and maintaining pricing models and tools to support the analysis and implementation of pricing strategies. This includes utilizing advanced analytics and statistical techniques to forecast the financial impact of pricing changes and simulate different scenarios.
• Collaborating with internal teams, such as finance, network management, and provider relations, to ensure alignment of pricing strategies and sharing insights. Communicating pricing strategies, changes, and updates to stakeholders, including senior management, network providers, and internal teams.
• Collaborating with cross-functional teams, such as finance, actuarial, and network management, to develop pricing strategies for pharmacy services. This involves considering factors like cost structures, market dynamics, network performance, and customer needs to determine optimal pricing approaches.
• Execute and implement dynamic pricing strategies in response to market fluctuations to provide competitive, profitable, and best of class pricing offerings
• Monitoring and evaluating the financial performance of pharmacy network contracts and pricing arrangements. This includes analyzing revenue and cost data, tracking key performance indicators (KPIs), identifying trends, and providing recommendations for optimizing profitability.
• Ensuring compliance with relevant pricing regulations, policies, and contractual obligations. This involves staying up to date with pricing-related laws and regulations, conducting audits, and collaborating with legal and compliance teams to mitigate pricing-related risks.
• Collecting, organizing, and managing pricing data, maintaining pricing databases, and generating regular reports on pricing performance, trends, and insights. This supports decision-making processes and provides transparency on pricing outcomes.
• Identifying opportunities for process improvement, automation, and efficiency enhancements in pricing analysis and strategy development. Contributing to ongoing initiatives to improve pricing methodologies, tools, and systems.
• Perform other job-related duties as assigned

What will you bring to SmithRx:

• Strong communication skills, both written and verbal, are important for effectively conveying pricing insights and collaborating with cross-functional teams, pharmacy providers, and internal stakeholders.
• Experience in conducting market research, monitoring industry trends, and assessing competitive pricing strategies is advantageous. Knowledge of regulatory changes and market dynamics that impact pharmacy pricing is beneficial.
• Strong attention to detail and accuracy is crucial for working with complex financial data, performing pricing calculations, and ensuring compliance with pricing regulations and contractual obligations.
• Familiarity with pricing methodologies, pricing strategies, and reimbursement models within the pharmacy or healthcare industry is beneficial. Knowledge of pharmacy network operations, fee schedules, and reimbursement rates is valuable for this role.
• The ability to analyze complex problems, think critically, and propose innovative solutions is valuable in this role. Strong problem-solving and decision-making skills are necessary for optimizing pricing strategies and addressing pricing-related challenges.
• Previous experience in pharmacy network pricing, healthcare pricing analysis, or a related field is highly desirable. This can include experience in areas such as pricing strategy development, financial analysis, contract negotiation, or healthcare reimbursement.
• Proficiency in using software tools for financial analysis, data modeling, and reporting is often required. Knowledge of Excel, SQL, or other relevant software is beneficial.
• Familiarity with contract negotiation processes and experience in analyzing pricing terms and conditions is valuable. Understanding of contract language, pricing clauses, and financial implications is beneficial.
• Bachelor's degree or 8+ years of experience in PBM, or relevant fields such as economics, finance, business administration, healthcare administration, or a related discipline is typically preferred.
• Extensive PBM industry knowledge and deep understanding of the financial levers of a PBM
• Strong analytical and quantitative skills are essential for conducting pricing analysis, modeling pricing scenarios, and interpreting financial data. Proficiency in data analysis and statistical tools, such as Excel, SQL, or data visualization software, is often required.

What SmithRx Offers You:

• Total Rewards package that includes incentive bonus and stock options
• Paid Parental Leave benefits
• Flexible Spending Benefits
• Professional development and training opportunities
• Commuter Benefits
• 401(k) Retirement Savings Program
• Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, Life insurance
• Discretionary Time Off