Manager, Clinical Review and Quality Assurance

Who We Are:

• SmithRx is a rapidly growing, venture-backed Health-Tech company with a mission to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector.
• We are guided by core values of Integrity, Courage, and Together, fostering a collaborative culture that empowers employees to drive meaningful change.

Job Summary:

• We are seeking a dynamic leader to manage the Clinical Review Operations and Quality Assurance function, ensuring integrity and efficiency of our prior authorization ecosystem.
• This role integrates QA oversight, technical system management, and medication policy execution, bridging business requirements with technical execution.

What you will do:

• Mentor and unify a high-performing team across QA, medication policy, and business analysis to drive organizational goals.
• Direct the PA quality assurance program, oversee interrater reliability audits, and lead platform strategy and clinical rule configuration.
• Provide pharmacotherapy expertise for P&T Committee activities, formulary management, and evidence-based medication policy development.