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Director, Clinical Review

Lehi, UT; Plano, TX; Remote

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:

  • 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 the status quo to keep moving forward—always.
  • Together: The success of SmithRx reflects the strength of our partnerships and the commitment of our team. Our shared values bind us together and make us one. When one falls, we all fall; when one rises, we all rise.

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.

In order to be eligible for this position applicants must be based in one of the following states: Arkansas, Arizona, California, Colorado, Florida, Georgia, Kansas, Minnesota, Missouri, Nevada, North Carolina, South Carolina, Ohio, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin.

What you will do:

  • Senior Leader of the Clinical Review team
  • Oversight of clinical decision-making aspects of SmithRx’s drug management programs.
  • Provide clinical guidance to staff as needed
  • 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 to 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 with current license in good standing in the relevant jurisdiction PharmD in co  required
  • 10 years of professional experience, including 5+ years in a people leadership or director role.
  • PBM experience strongly preferred
  • 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
  • Robust analytical skills; advanced skills in Microsoft Excel
  • Experience with excel 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

What SmithRx Offers You: 

  • Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance
  • Flexible Spending Benefits 
  • 401(k) Retirement Savings Program 
  • Short-term and long-term disability
  • Discretionary Paid Time Off 
  • 12 Paid Holidays
  • Wellness Benefits
  • Commuter Benefits 
  • Paid Parental Leave benefits
  • Employee Assistance Program (EAP)
  • Well-stocked kitchen in office locations
  • Professional development and training opportunities

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