Manager, Clinical Review and Quality Assurance

What you will do: Team Leadership: Mentor and unify a high-performing team across QA, medication policy, and business analysis to drive organizational goals. Quality Assurance: Direct the PA quality assurance program, overseeing interrater reliability audits and reviewing team performance. Platform Management: Lead PA platform strategy, technical enhancements, data governance, and clinical rule configuration for optimal efficiency. Clinical Strategy: Provide pharmacotherapy expertise for P&T Committee activities, formulary management, and evidence-based medication policy development. Process Improvement: Drive technology enhancements and monitor key performance metrics using data-driven insights. Change Management: Facilitate process documentation, lead User Acceptance Testing (UAT), and manage stakeholder training for system releases. What you will bring to SmithRx: Education: Doctor of Pharmacy (PharmD) required. Licensure: Active, unrestricted Registered Pharmacist (RPh) license. Experience: 10+ years in clinical pharmacy, specifically within Health Plan or PBM environments. Technical Proficiency: 5+ years supporting PA platforms, including ePA standards (NCPDP) and rule configuration (e.g., Banjo Health, MHK). Domain Expertise: Strong background in QA best practices, clinical utilization review, P&T committee support, and regulatory compliance. Analytical Skills: Proven ability to translate complex data and business requirements into actionable system changes. Soft Skills: Exceptional communication and influencing skills with a bias for action in fast-paced environments. 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 Zone A includes the following locations: San Francisco Bay Area - California Metro New York City - Connecticut, New Jersey, New York and Pennsylvania Zone A Pay Range $163,200 — $192,000 USD Zone B includes the following locations: California - outside of San Francisco Bay Area Metro Denver / Boulder - Colorado Metro District of Columbia - District of Columbia, Maryland, Virginia and West Virginia Metro Boston / Cambridge - Massachusetts and New Hampshire Metro Austin - Texas Metro Seattle - Washington Zone B Pay Range $149,600 — $176,000 USD Zone C includes all other locations not listed above, including: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Wisconsin, Wyoming Non metro Colorado, Connecticut, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Texas, Virginia, Washington, and West Virginia Zone C Pay Range $136,000 — $160,000 USD Compensation & Benefits Base Salary: The range listed above reflects our standard pay scale and actual pay will vary based on work location, job level, job-related knowledge, skills, and experience. Total Rewards: In addition to base pay, this role may be eligible for bonuses, commissions, or equity. SmithRx offers a variety of benefits to help you live well, including: time off programs, medical, dental, vision, mental health support, paid parental leave, life and disability insurance and 401(k). Individual offers are tailored to your geography, experience, skills, and education. Your recruiter can share more specific details during the hiring process. In the meantime, feel free to explore our comprehensive benefits here .