# Manager, Clinical Review and Quality Assurance

**Company:** [SmithRx](https://hotfix.jobs/companies/smithrx)
**Location:** Remote
**Role:** Engineering Management
**Salary:** $136k – $192k/yr
**Experience:** 10+ years
**Skills:** Pharmd, Registered Pharmacist License, Clinical Pharmacy, Prior Authorization, Quality Assurance, Ncpdp, Banjo Health, Mhk, Data Governance, User Acceptance Testing, Formulary Management, Regulatory Compliance
**Posted:** 2026-09-02

> Leads clinical review and prior authorization quality programs while managing platform strategy, medication policy, and a cross-functional team. Requires a PharmD, unrestricted RPh license, and 10+ years of clinical pharmacy experience in health plan or PBM environments.

## Job Description

## Responsibilities
- Mentor and unify a high-performing team spanning quality assurance, medication policy, and business analysis.
- Direct the prior authorization quality assurance program, including interrater reliability audits and team performance reviews.
- Lead prior authorization platform strategy, technical enhancements, data governance, and clinical rule configuration.
- Provide pharmacotherapy expertise for Pharmacy and Therapeutics Committee activities, formulary management, and evidence-based medication policy development.
- Drive process and technology improvements using key performance metrics and data-driven insights.
- Document processes, lead User Acceptance Testing (UAT), and manage stakeholder training for system releases.

## Requirements
- Doctor of Pharmacy (PharmD) degree.
- Active, unrestricted Registered Pharmacist (RPh) license.
- 10+ years of clinical pharmacy experience in health plan or pharmacy benefit manager environments.
- 5+ years supporting prior authorization platforms, including ePA standards and rule configuration.
- Strong experience with quality assurance practices, clinical utilization review, Pharmacy and Therapeutics Committee support, and regulatory compliance.
- Ability to translate complex data and business requirements into actionable system changes.
- Exceptional communication and influencing skills.

## Preferred Experience
- Experience with NCPDP, Banjo Health, or MHK.

## Compensation and Benefits
- Annual base salary range of $136,000–$192,000 USD, varying by geographic zone.
- Eligibility for bonuses, commissions, or equity may apply.
- Medical, pharmacy, dental, vision, life, AD&D, short- and long-term disability insurance.
- Flexible spending benefits, 401(k), discretionary paid time off, company holidays, wellness and commuter benefits.
- Paid parental leave, employee assistance program, and professional development and training opportunities.

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