Director, Clinical Review

Lehi, Utah, United States

Apply with AI Apply

Not SpecifiedCompensation

Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Health-Tech, Pharmacy Benefit ManagementIndustries

Requirements

Candidates must possess a PharmD with a current license in good standing in the relevant jurisdiction and have 10 years of professional experience. Applicants must be based in Arkansas, Arizona, California, Colorado, Florida, Georgia, Kansas, Minnesota, Missouri, Nevada, North Carolina, South Carolina, Ohio, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, or Wisconsin.

Responsibilities

The Director of Clinical Review will serve as a senior leader for the Clinical Review team, overseeing clinical decision-making for drug management programs and providing clinical guidance and mentorship to staff. They will be accountable for customer satisfaction related to the review process, support client-facing meetings, and resolve cross-functional issues for client escalations. Responsibilities also include collaborating with sales on RFP documents, leading evaluations for improved drug management through clinical research and analytics, identifying and executing process improvements, evaluating tools and resources to drive workflow, forecasting and managing staffing and budgets, creating a positive team environment, and monitoring team performance through KPIs and data analytics. Some travel may be required.

Skills

Clinical Review

Utilization Management

Formulary Adherence

Medical Appropriateness

PBM

Health-Tech

Leadership

Clinical Programs

SmithRx

Pharmacy benefit management with transparent pricing

About SmithRx

SmithRx operates as a Pharmacy Benefit Manager (PBM) that focuses on managing prescription drug plans for self-insured employers and plan sponsors. The company uses a transparent pricing model called "Pass Through Pricing," where it charges only an administrative fee and passes all rebates from prescriptions directly to clients and their members. This model contrasts with traditional PBMs that often inflate drug prices and retain rebates for profit. SmithRx's clients benefit from a technology platform that utilizes real-time data to improve service delivery, ensuring efficient and high-quality pharmacy benefit management. The company also provides a concierge service to enhance support for both members and clients. SmithRx aims to simplify pharmacy benefits while maximizing value for its clients through transparency, advanced technology, and exceptional customer service.

San Francisco, CaliforniaHeadquarters

2016Year Founded

$94.8MTotal Funding

SERIES_CCompany Stage

HealthcareIndustries

201-500Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Health Savings Account/Flexible Spending Account

Unlimited Paid Time Off

Paid Holidays

Wellness Program

Commuter Benefits

Parental Leave

Mental Health Support

Professional Development Budget

Risks

Increased competition from technology-driven PBMs like Capital Rx could erode market share.

Rapid technological advancements may require costly updates to SmithRx's platform.

Potential regulatory scrutiny on PBM pricing models could impact SmithRx's business model.

Differentiation

SmithRx uses a transparent 'Pass Through Pricing' model, unlike traditional PBMs.

The company leverages real-time data for efficient pharmacy benefit management services.

SmithRx offers concierge-level service, enhancing customer satisfaction and support.

Upsides

SmithRx secured $60M in Series C funding, indicating strong investor confidence.

Partnership with Banjo Health enhances prior authorization processes using AI technology.

Collaboration with TheracosBio offers cost-effective drug options for Type 2 Diabetes.

Land your dream remote job 3x faster with AI

Try Jobo Free