Director, Clinical Review

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.  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 of:

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

Job Summary

The Clinical Review team helps SmithRx’s clients derive the full value of their PBM services through reviewing for medial appropriateness, formulary adherence and other clinical controls utilized to drive members to the therapy they need at the lowest cost under their benefit plan.

As the Director of Clinical Review, you will be responsible for support and execution of the clinical utilization programs.  Serve as a clinical resource throughout the organization related to utilization management and support all clinical pharmacy programs.  Lead the team to optimize quality, efficiency, and productivity within sound clinical guidelines.

What you will do: 

  • Lead and manage the Clinical Review team comprising of Pharmacists and Pharmacy Technicians
  • Provide mentorship and career development for all level of employees of the team.
  • Accountable for customer satisfaction, including members, physicians, and clients, related to the review process
  • Support and attend client-facing meetings as needed related to the clinical processes
  • Work with internal leaders to resolve cross-functional issue resolution for client escalations
  • Collaborate with the sales team to provide information in support of RFP documents
  • Leads evaluation and identification opportunities for improved management of pharmacy benefit drugs through clinical research and analytics that improve medical cost savings and provide clinical quality initiatives
  • Identify and execute process improvements on an on-going basis with a focus on improving member experience, employee satisfaction, and employer cost
  • Identify and evaluate tools and resources, such as technology, to drive workflow within the team
  • Forecast and manage staffing, including but not limited to interview, hire, training, and budgets for the function
  • Create and maintain a positive and collaborative team environment
  • Monitor and manage team performance through KPI’s and data analytics
  • Some travel may be required

What you will bring to SmithRx:

  • PharmD required
  • 10 years of healthcare experience, preferably in PBM space
  • 7+ years of leadership experience, including managing diverse teams
  • 5+ years of relevant experience owning, building, and delivering timely deliverables for complex initiatives and workstreams
  • Demonstrated leadership skills (e.g., managing Pharmacists, Pharmacy Technicians, vendors) required
  • Ability to work independently as well as part of an extended, cross-functional team
  • Conflict resolution skills
  • Empathetic communicator with a consultative approach, able to see things from other person's point of view
  • Advanced level proficiency in MS office (Excel, Powerpoint, and Word) and data analysis
  • Strong communication skills via face-to-face meetings, conference calls and written correspondence
  • Self-starter mentality: ability to make informed decisions, find creative approaches to difficult challenges, and deliver on commitments
  • Execution-focused ethos - you are a solutions-oriented problem solver and efficiency driven
  • Flexible, adaptable, and able to respond under the pressure of a fast-paced technology company
  • 20-25% travel required

Location
Lehi, UT; San Francisco, CA; Remote
Team
Clinical Services

Partnering with SmithRx to provide transparent pharmacy benefits helps us deliver low-cost, high-quality care. Their pass-through model is the best way to ensure prescription drug pricing is fair.

Will Young
CEO at Sana Benefits

My loudest and most challenging group was handled perfectly in the first 30 days post-go-live by SmithRx. If it were up to me, I would put every one of my new groups with SmithRx.

Ken Mensio
Vice President at Risk Strategies

Ready to make the leap?

Ready to make the leap?

99%+

client retention

1,200+

employers served

50%

potential RX savings