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.
Job Summary:
SmithRx is looking for a motivated manager to help manage a team of Prior Authorization Pharmacists. This role is pivotal in driving daily performance of the prior authorization team by ensuring high-quality reviews, adhering to turnaround times, and delivering exceptional member experiences. Your primary focus will be the coaching and mentoring of your team as well as driving performance through the measurement of key performance indicators.
What You Will Do:
- 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, hire, train, and onboard new team members.
- Provide day-to-day supervision, support, and an escalation path for Pharmacists.
- Manage the team to meet target KPIs associated with the operating model.
- Identify and drive areas for operational process improvements to support scale.
- Collaborate cross-functionally regarding eligibility questions, claims adjudication, and benefit designs.
- Participate in the Pharmacy and Therapeutics Committee process to develop clinical criteria for medications.
- Serve as a change champion when new technology is implemented to improve processes.
What You Will Bring:
- 5+ years of health plan or pharmacy benefit manager experience, specifically involved in prior authorization review.
- 3-5+ years of management experience.
- Familiarity with regulatory (ERISA, ACA, Medicare) and accreditation requirements (URAC, NCQA).
- Proficiency in Mac, MS Office, and G-Suite.
- Strong active listening and conversational speaking skills with high empathy.
- Ability to communicate complex information clearly to diverse stakeholders.
- Demonstrated knowledge of drug product/dose calculations and general pharmacy information.
- Bachelor’s degree in Pharmacy or Doctor of Pharmacy (PharmD) and an active Pharmacist License.