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Manager, Clinical Review and Quality Assurance

SmithRx
Location
Remote
Posted
19 days ago
Department
Utilization Management
What they actually want (must-haves)
  • Doctor of Pharmacy (PharmD) required
  • Active, unrestricted Registered Pharmacist (RPh) license
  • 10+ years in clinical pharmacy, specifically within Health Plan or PBM environments
  • 5+ years supporting PA platforms, including ePA standards (NCPDP) and rule configuration
  • Strong background in QA best practices, clinical utilization review, P&T committee support, and regulatory compliance
  • Proven ability to translate complex data and business requirements into actionable system changes
What the job really is

The Manager, Clinical Review and Quality Assurance at SmithRx is responsible for overseeing the integrity and efficiency of the prior authorization ecosystem. This role involves leading a team across quality assurance, medication policy, and business analysis while managing platform strategy and clinical rule configuration. The position also requires driving process improvements and facilitating change management through stakeholder training and documentation.

Benefits
  • 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
  • Paid Company Holidays
Things to weigh
  • No specific mention of remote work policies or expectations
  • Salary varies significantly by location, with a wide range depending on geography
  • The role requires a strong technical background in PA platforms which may limit candidates without this experience
Job score3.4/5
Benefits5/5
Freshness4/5
Career value4/5
Role clarity4/5
Pay transparency0/5

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