Lead, Clinical Review Pharmacist

Related keywords: pharmacist remote jobhealth coach remote jobremote job in healthcare

Overview

SmithRx is a leading health-tech company that has rapidly evolved in the healthcare landscape, focusing particularly on Pharmacy Benefit Management (PBM). Their mission is to overhaul traditional PBM systems, striving to enhance efficiency and reduce costs in the healthcare sector. As a part of this innovative team, you'll play a critical role in fundamentally changing how pharmacy services are managed in the U.S.

Company Mission and Values

SmithRx's core mission is to provide a next-generation drug acquisition platform that integrates advanced technology, effective cost-saving tools, and exemplary customer service. SmithRx believes in a collaborative culture bolstered by strong values:

1. Integrity: Acting with honesty and dependability while embracing the challenges inherent in the healthcare sector.
2. Courage: Encouraging resilience and the continuous pursuit of innovation while supporting team members.
3. Together: Fostering a sense of partnership and support among team members to enhance overall workplace success.

Job Summary

The position available is Lead Clinical Review Pharmacist, which involves managing a team focused on prior authorizations. This role is integral in delivering high-quality reviews, ensuring timely processing, and enhancing member experiences. Key responsibilities include:

• Direct management, coaching, and mentoring of a team of prior authorization pharmacists.
• Ensuring compliance with regulatory standards and maintaining excellent performance metrics.
• Driving operational improvements to support growth and scalability of services.

Responsibilities

In this leadership role, you will be responsible for several critical tasks:

• Team Management: Oversee, coach, and mentor the clinical review pharmacists on your team. Your leadership will play a crucial role in their professional development.

• Regulatory Compliance: Ensure that your team meets all required regulatory, accreditation, and compliance standards related to clinical review processes.

• Recruitment and Training: Actively participate in the recruitment process and lead the training and onboarding of new team members.

• Performance Management: Drive the performance of your team by setting key performance indicators (KPIs) and ensuring that the team meets them consistently.

• Cross-Functional Collaboration: Work closely with other departments to resolve eligibility questions and support claims adjudication.

  

• Process Improvement: Identify and implement process improvements to enhance team efficiencies and member experiences.

• Technology Integration: Act as a champion of change in adopting new technologies and improving existing processes to scale operations.

Required Skills

Candidates applying for the Lead Clinical Review Pharmacist position should possess the following qualifications:

1. A minimum of 5 years of experience in health plan or pharmacy benefit management, particularly in prior authorization review.
2. 3-5 years of management experience to adequately lead a team of clinical pharmacists.
3. Familiarity with regulatory compliance requirements such as ERISA, ACA, and accreditation bodies like URAC and NCQA.
4. Proficiency in relevant software tools (Mac, MS Office, G-Suite) and strong communication skills.
5. A Bachelor’s degree in Pharmacy or a Doctor of Pharmacy (PharmD) with an active pharmacist license is required.

Compensation and Benefits

While specific salary details are not provided, SmithRx promises a highly competitive salary along with a comprehensive benefits package that includes:

• Medical, Pharmacy, Dental, Vision, as well as Life and AD&D Insurance.
• Flexible Spending Benefits and a 401(k) Retirement Savings Program.
• Options for short- and long-term disability and Paid Time Off (PTO).
• Paid parental leave benefits and access to an Employee Assistance Program (EAP).
• Professional development opportunities, ensuring continuous growth.

Work Environment

SmithRx promotes a flexible working environment, where remote work is facilitated to support work-life balance. Their commitment to employee wellness and a collaborative culture makes it an attractive workplace for dedicated professionals in the health-tech sector.

Conclusion

As a Lead Clinical Review Pharmacist, you will play a significant role in reshaping the healthcare landscape by leading a team focused on improving pharmacy management practices. This position offers a unique opportunity for growth and impact, ensuring superior member experiences by optimizing clinical review processes. If you are seeking a rewarding and challenging role in a thriving company, consider applying for this position at SmithRx, where innovation meets compassion.

This job offer was originally published on himalayas.app