SmithRx - Lead, Clinical Review Pharmacist

• Directly manage, coach, and mentor a team of prior authorization Pharmacists • Responsible for driving and maintaining regulatory, compliance, and accreditation standards on the clinical review team • Recruit and hire new team members • Lead training and onboarding for all new team members • Provide day-to-day supervision, support, and escalation path for Pharmacists on your team • Manage team to meet target KPIs associated with our operating model • Ensure efficient allocation of operations center resources and maintain high performance standards • Identify and drive areas for operational process improvements to support scale • Cross-functional collaboration with other departments including troubleshooting eligibility questions, claims adjudication, and benefit designs • Motivates Pharmacist growth and performance through coaching interactions • Drive quality member experiences by ensuring Clinical Review team policy and procedures are adhered to • Responsible for scheduling to drive consistent capacity • Responsible for execution of goals, and objectives of direct reports. • Collaborate with Pharmacists within the Pharmacy and Therapeutics Committee process and participate in development of clinical criteria for medications requiring prior authorization • Work with cross functional teams to further SmithRx’s mission, vision, values and goals • Identify current process gaps and solve them using technology, process and people • When new technology is delivered service as a change champion and improve processes to scale the business and drive efficiencies • 5+ years of health plan or pharmacy benefit manager experience, specifically involved in prior authorization review • 3-5+ years of management experience required • Familiarity with various regulatory (ERISA, ACA, Medicare) and accreditation requirements (URAC, NCQA) • Proficiency in Mac, MS Office, G-Suite required • Active listening, conversational speaking skills, with a high degree of empathy • Self-starter with ability to multitask, prioritize and manage time effectively • Ability to communicate clearly, present complex information to members, clients, pharmacies, providers, and other teams internally • Ability to work accurately within protocols and follow appropriate escalation pathways for unique situations or where clarification is needed. • Flexibility and ability to adapt to changes and updates to technology, processes and protocols • Demonstrate accurate drug product/dose calculations for appropriate claim adjudication and knowledge of general pharmacy and drug product information for the prescription filling process • Bachelor’s degree in Pharmacy or Doctor of Pharmacy (PharmD) required • Active Pharmacist License required • 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 • Paid Company Holidays • Wellness Benefits • Commuter Benefits • Paid Parental Leave benefits • Employee Assistance Program (EAP) • Well-stocked kitchen in office locations • Professional development and training opportunities