[All remote jobs](https://jobicy.com/jobs.md)[![SmithRx logo](https://jobicy.com/data/server-nyc0409/galaxy/mercury/2025/07/fa1482ea-221.jpeg)](https://jobicy.com/company/smithrx.md)[SmithRx](https://jobicy.com/company/smithrx.md) # Clinical Review Pharmacist (6-month, full-time contract) Review the role, location requirements, compensation details, and application process before deciding whether this opportunity fits your next career move. [Apply for this job](#job-application)[View company](https://jobicy.com/company/smithrx.md)ShareRemote from[USA](https://jobicy.com/job-region/usa.md)SalaryUSD 63–66 / hourDepartment[Healthcare & Medical](https://jobicy.com/categories/healthcare.md)EmploymentContractExperienceOpen levelPublished20 Oct 2026Apply before19 Nov 2026Listing views45Application actions1Application toolkit ## Make your next move. Prepare your resume, explore your fit, and draft a cover letter for this opportunity. AI Summary ## The role, at a glance. SmithRx is hiring a licensed Clinical Review Pharmacist for a six-month, full-time remote contract supporting pharmacy benefit management operations. The pharmacist will make evidence-based prior authorization and appeal decisions, document determinations, and ensure adherence to HIPAA, URAC/NCQA, and applicable regulations. The role also involves responding to members, prescribers, and pharmacies, identifying potential fraud, waste, and abuse, and contributing to process improvements. Candidates need an active unrestricted pharmacist license in their state of residence, a PharmD or BS Pharmacy, and at least two years of pharmacy practice experience. Prior utilization management, managed-care, and PBM experience are preferred. ## Role DNA A quick view of the complexity, pace, ownership and collaboration implied by the job description. ### Job Complexity 4/5EasyHard ### Pace & Pressure 5/5RelaxedFast-paced ### Autonomy Level 4/5GuidedFull ownership ### Communication Load 5/5IndependentCollaborative AI insightThis role requires independent clinical judgment on time-sensitive utilization-management decisions while maintaining strict regulatory and documentation standards. The high-volume, metric-driven environment and communication with multiple healthcare stakeholders add complexity. ## Salary analysis Estimated compensation compared with the broader US market for similar roles. Estimated job median (per hour)Market rate$64.50US market range (per hour)$60–$700$77 AI insightThe hourly pay period is inferred from the job context; it was not explicitly stated by the employer. Employer base pay is explicitly stated as $63–$66 USD per hour across U.S. location zones, with a midpoint of $64.50 per hour. Estimated U.S. market compensation for an experienced remote clinical review pharmacist is approximately $60–$70 per hour; actual pay varies by licensure, managed-care experience, and location. ## Core skills Skills and capabilities most closely associated with this opportunity. [Prior authorization review](https://jobicy.com/jobs?search_keywords=Prior%20authorization%20review.md)[Clinical appeals](https://jobicy.com/jobs?search_keywords=Clinical%20appeals.md)[Utilization management](https://jobicy.com/jobs?search_keywords=Utilization%20management.md)[Pharmacy benefit management](https://jobicy.com/jobs?search_keywords=Pharmacy%20benefit%20management.md)[Clinical guideline application](https://jobicy.com/jobs?search_keywords=Clinical%20guideline%20application.md)[Formulary management](https://jobicy.com/jobs?search_keywords=Formulary%20management.md)[Step therapy evaluation](https://jobicy.com/jobs?search_keywords=Step%20therapy%20evaluation.md)[Quantity limit review](https://jobicy.com/jobs?search_keywords=Quantity%20limit%20review.md)[HIPAA compliance](https://jobicy.com/jobs?search_keywords=HIPAA%20compliance.md)[URAC standards](https://jobicy.com/jobs?search_keywords=URAC%20standards.md)[NCQA standards](https://jobicy.com/jobs?search_keywords=NCQA%20standards.md)[Pharmacist licensure](https://jobicy.com/jobs?search_keywords=Pharmacist%20licensure.md)[Drug information](https://jobicy.com/jobs?search_keywords=Drug%20information.md)[Clinical documentation](https://jobicy.com/jobs?search_keywords=Clinical%20documentation.md)[Provider communication](https://jobicy.com/jobs?search_keywords=Provider%20communication.md) Sample interview questionsHow do you approach a prior authorization request when the available information is incomplete?I first compare the submission with the applicable benefit criteria and clinical guideline, then identify the specific missing clinical facts needed for a determination. I document the gap clearly and request additional information from the prescriber or appropriate party while following required turnaround times. Describe how you balance timely decisions with clinical accuracy in a high-volume environment. I use a structured review workflow that prioritizes requests by regulatory and clinical urgency, verifies key criteria consistently, and documents decisions as I go. I escalate ambiguous or complex cases promptly rather than making assumptions, which protects both timeliness and decision quality. What would you do if a prescriber disagreed with an adverse coverage determination? I would communicate the decision respectfully, explain the relevant criteria and clinical rationale in plain language, and outline available next steps such as providing additional documentation or pursuing an appeal. I would remain empathetic while ensuring that all interactions and decisions are accurately documented. How do you stay current on prescribing guidelines and regulatory changes? I maintain a regular learning routine using clinical literature, professional pharmacy resources, internal policy updates, and formal training. I translate relevant changes into my review practice and seek clarification from clinical leadership when policy interpretation is needed. How would you identify and report potential fraud, waste, and abuse during a clinical review? I would look for inconsistent clinical documentation, unusual prescribing patterns, duplicate therapies, or requests that do not align with documented medical need. I would preserve objective records, avoid making unsupported conclusions, and report the concern through the established compliance or FWA process. Opportunity details ## About this role. 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. With hundreds of thousands of members onboarded since 2016, SmithRx has a solution that is resonating with clients all across the country. We pride ourselves for our mission-driven and collaborative culture that inspires our employees to do their best work. We believe that the U.S healthcare system is in need of transformation, and we come to work each day dedicated to making that change a reality. At our core, we are guided by our company values: * Integrity: Our purpose guides our actions and gives us confidence in the path ahead. With unwavering honesty and dependability, we embrace the pressure of challenging the old and exemplify ethical leadership to create the new. * Courage: We face continuous challenges with grit and resilience. We embrace the discomfort of the unknown by balancing autonomy with empathy, and ownership with vulnerability. We boldly challenge the status quo to keep moving forward—always. * Together: The success of SmithRx reflects the strength of our partnerships and the commitment of our team. Our shared values bind us together and make us one. When one falls, we all fall; when one rises, we all rise. Job Summary: Joining SmithRx’s clinical team, the Clinical Review Pharmacist plays a key role in enhancing clinical offerings and improving outcomes for our members and clients. Operating in a collaborative and fast-paced environment, this position pairs clinical expertise with service excellence to review prior authorization requests, support clinical programs, and offer guidance to providers, pharmacies, and members. What you will do: * Review and make timely, evidence-based decisions on prior authorizations and appeals using clinical guidelines and benefit criteria. * Ensure compliance with federal, state, and internal regulations across applicable lines of businesses . * Accurately document clinical decisions and maintain thorough records in accordance with regulatory and accreditation (URAC/NCQA) utilization review standards. * Provide clear, empathetic support to members, prescribers, and pharmacies by responding to clinical inquiries, demonstrating professionalism, active listening, and a patient-centered approach. * Stay current with clinical prescribing guidelines, internal policies, and regulatory changes, and apply them to daily responsibilities. * Follow all internal procedures, job aids, and HIPAA guidelines to protect patient privacy and data security. * Identify and report potential fraud, waste, and abuse (FWA). * Support training and development of new and existing team members as needed. * Assist leadership with special projects, process improvements, and operational initiatives ### What you will bring to SmithRx: Minimum Qualifications: * Doctor of Pharmacy (PharmD.) or Bachelor of Science in Pharmacy (B.S. Pharm) from an ACPE-accredited school of pharmacy * Active, unrestricted, pharmacist license in state of residence * Minimum of 2 years of pharmacy practice experience * Strong communication, writing, and organizational skills * Ability to manage multiple priorities in a high-volume, metric-driven environment * General understanding of drug information, clinical guidelines, formulary design, and utilization management strategies * Flexible and adaptable to changes * Availability to work after hours, weekends, and holidays on a rotating or fixed schedule Preferred Qualifications: * One year of prior authorization or utilization management experience * One year experience in managed care or pharmacy benefit management (PBM) * Direct experience conducting prior authorization reviews, clinical appeals, formulary exceptions, step therapy evaluations, and quantity limit reviews * Experience in Google Workspace (Gmail, Docs, Sheets, and Drive) Location: US – Remote 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 $64—$66 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 $63—$65 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 $63—$65 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](https://benefitsguides.thinkccig.com/smithrx/2026candidates/). 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