EDI Integration Specialist

2 months ago

Lehi, Utah, United States SmithRx Full time
Job Overview

About Us:

SmithRx is an innovative and rapidly expanding Health-Tech organization. Our objective is to transform the costly and ineffective Pharmacy Benefit Management (PBM) industry by creating a state-of-the-art drug acquisition platform that leverages advanced technology, inventive cost-saving solutions, and exceptional customer service. Since our inception in 2016, we have successfully onboarded hundreds of thousands of members, providing a solution that resonates with clients nationwide.

We take pride in our mission-driven and collaborative culture, which motivates our employees to perform at their best. We believe in the necessity of transforming the U.S. healthcare system, and we are committed to making that change a reality. Our core values guide us:

  • Integrity: We operate with honesty and transparency to earn our clients' trust.
  • Courage: We embrace the bravery required to tackle a flawed industry and continually enhance our offerings to optimize health outcomes.
  • Collaboration: We cultivate an inclusive environment that values teamwork, respect, open communication, and encourages creativity and diverse perspectives.

Position Summary:

The EDI Integration Specialist will be an integral part of SmithRx's expanding Adjudication Platform Team. This role involves collaborating across various business and technology sectors to design and implement efficient solutions for electronic data integration workflows. The candidate will support the team in crafting processes that facilitate essential PBM file exchanges, contributing to the ongoing success of SmithRx and our clients. Our mission is to assist our business partners while effectively promoting a streamlined data file sharing process for all stakeholders.

As we experience rapid growth, there is a pressing need to support the implementation phase for all new SmithRx clients. The implementation and integration technical team is responsible for critical tasks related to electronic data interchange (EDI) and file management. This team serves as the primary resource to ensure successful data exchanges between SmithRx and our clients, collaborating with various internal and external partners to guarantee seamless execution for members, clients, and other key stakeholders.

Key Responsibilities:

  • Ensure that project implementation resources are executing the solution implementation promptly and in line with the design.
  • Act as the main technical contact for all eligibility and data integration discussions.
  • Clarify technical implementation roles and responsibilities to clients.
  • Participate in implementation meetings to provide insights on our technical integration processes.
  • Empower clients through training on SmithRx's data integration solutions.
  • Lead or assist in solution configuration and quality assurance tasks.
  • Engage in implementation activities (including technical tasks) as necessary to meet project timelines and deliverables.
  • Troubleshoot and resolve ongoing electronic data sharing issues, including eligibility, accumulator, and paid claim file formats, SFTP connectivity, data ingestion, and data accuracy.
  • Develop expertise in SmithRx data process flows to serve as the EDI expert for clients.
  • Provide product knowledge and expertise to implementation staff, clients, and other stakeholders.
  • Oversee implementation resources on project execution without direct managerial authority.
  • Manage integrations with third-party systems.
  • Communicate effectively with technical, business, and non-technical team members.
  • Exhibit excellent organizational and multitasking skills, attention to detail, self-motivation, and a commitment to success.

Qualifications:

  • Bachelor's degree or equivalent experience preferred.
  • 4-6 years of EDI experience required.
  • Experience in pharmacy claims adjudication (NCPDP) preferred.
  • Intermediate proficiency in SQL (preferably PostgreSQL).
  • Intermediate proficiency in Microsoft Excel.
  • Strong analytical skills with the ability to think critically about data and data flow.
  • General understanding of healthcare industry stakeholders (PBMs, EHRs, TPAs, Aggregators, Pharmacies).
  • Excellent communication skills, both verbal and written.
  • Self-starter mentality with the ability to make informed decisions and creatively approach challenges.
  • Execution-focused mindset, emphasizing solutions-oriented problem-solving and efficiency.
  • Adaptable and capable of responding under the pressures of a fast-paced technology environment.

What We Offer:

  • 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 coverage.
  • Discretionary Paid Time Off.
  • 12 Paid Holidays.
  • Wellness Benefits.
  • Commuter Benefits.
  • Paid Parental Leave.
  • Employee Assistance Program (EAP).
  • Well-stocked kitchen in office locations.
  • Opportunities for professional development and training.

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