Medical Claims Operations Manager

4 weeks ago


Plano, Texas, United States SmithRx Full time

At SmithRx, we're revolutionizing the Pharmacy Benefit Management (PBM) sector with cutting-edge technology and innovative cost-saving tools. As a Medical Claims Operations Manager, you'll play a pivotal role in our mission to transform the healthcare system.

As a key member of our Patient Access Programs Team, you'll oversee the operational performance and efficiency of our team responsible for procuring medications through drug manufacturers. Your team serves as our patients' advocate, guiding them through the complex world of prescriptions to obtain medications in a cost-effective and timely manner.

Key responsibilities include:

  • Directly managing, coaching, and mentoring a team of patient advocates
  • Leading training and onboarding for new team members
  • Providing day-to-day supervision, support, and escalation path for patient advocates
  • Leading the team to meet patient advocate team target KPIs
  • Ensuring efficient allocation of operational center resources and maintaining high-performance standards
  • Identifying and driving areas for operational process improvements to support efficiency and scale

Requirements include:

  • At least 5 years of management experience in a healthcare setting leading teams in operations and/or customer service
  • Experience managing Team Leads and/or Managers required
  • HS diploma or GED or equivalent work experience
  • Previous experience helping patients/members with healthcare
  • Passion for mentoring and helping team members with career pathing and skills enhancement
  • Previous experience with healthcare, pharmacy benefits, and/or claims processing a plus

We offer a highly competitive wellness benefits package, including Medical, Pharmacy, Dental, Vision, and Life Insurance, as well as Flexible Spending Benefits, 401(k) Retirement Savings Program, Short-term and long-term disability, 12 Paid Holidays, Employee Assistance Program, and a well-stocked kitchen in office locations.



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