SmithRx is a pharmacy benefits partner built on a modern technology platform that creates new levels of flexibility, efficiency, and customer satisfaction. Backed by Venrock.
About the role
SmithRx is looking for a dynamic and experienced leader to serve as the Manager, Clinical Review Operations and Quality Assurance. This pivotal role is responsible for the integrity, efficiency, and clinical strategy of our prior authorization (PA) ecosystem. You will lead a multidisciplinary function, integrating Quality Assurance (QA) oversight, technical system management, and medication policy execution.
What they're looking for
- Team Leadership: Mentor and unify a high-performing team across QA, medication policy, and business analysis to drive organizational goals
- Quality Assurance: Direct the PA quality assurance program, overseeing interrater reliability audits and reviewing team performance
- Platform Management: Lead PA platform strategy, technical enhancements, data governance, and clinical rule configuration for optimal efficiency
- Clinical Strategy: Provide pharmacotherapy expertise for P&T Committee activities, formulary management, and evidence-based medication policy development
- Process Improvement: Drive technology enhancements and monitor key performance metrics using data-driven insights
- Change Management: Facilitate process documentation, lead User Acceptance Testing (UAT), and manage stakeholder training for system releases
More about this role
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...
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