Clinical Pharmacist Supervisor (RPh Supervisor)

Position Summary

The Clinical Pharmacist Supervisor (RPh Supv) serves as the primary clinical anchor, mentor, and escalation point for the Clinical Pharmacist I and II teams.

This role balances expert-level clinical review with vital leadership accountabilities, ensuring clinical accuracy, operational efficiency, and regulatory compliance across all prior authorization and appeals workflows.

The RPh Supv acts as the first line of defense for complex clinical dilemmas, conducts quality oversight, and partners closely with management to develop, coach, and scale the clinical team.

Additionally, this role oversees core administrative team functions, including PTO coordination, schedule management, and capacity planning to ensure continuous, compliant clinical queue coverage.

Essential Functions

Team Leadership & People Development

Primary Clinical Escalation Point: Serve as the immediate operational and clinical resource for the Clinical Pharmacist I and II teams regarding complex case rationales, ambiguous criteria interpretation, and difficult Peer-to-Peer strategies.

Coaching & Mentorship: Provide daily guidance, mentorship, and clinical coaching to team members to ensure professional skill development and consistent, high-quality performance.

Clinical Capacity & Schedule Administration: Manage the operational scheduling and PTO requests for the clinical pharmacist team. Proactively plan and balance team capacity against fluctuating case volumes to ensure baseline staffing levels are continuously maintained and strict turnaround time (TAT) SLAs are met.

Performance Management: Collaborate with the Clinical Pharmacist Operations Manager to identify areas for skill elevation; develop tailored improvement frameworks and deliver dedicated mentorship to successfully bridge performance variations and help team members excel

Recruitment Support: Actively participate in the recruitment and interviewing process to identify and vet top-tier clinical talent for the expanding team.

Autonomous Problem Solving: Resolve operational or systemic friction within the pharmacist queue independently whenever possible, or escalate to management with full context and structured solutions.

Clinical Training & Knowledge Management

Advanced Clinical Training: Lead ongoing clinical training and continuing education initiatives for the pharmacist team post-onboarding, ensuring mastery of internal platforms, PBM architectures, and clinical drug databases.

Material Development: Proactively identify knowledge gaps on the floor; design and update clinical reference materials, tip sheets, and training modules to reflect formulary updates, regulatory shifts, or new comparative effectiveness data.

Regulatory Compliance Oversight: Monitor and reinforce adherence to strict quality benchmarks and industry compliance standards (e. g., URAC, NCQA, CMS guidelines).

Advanced Operations & Quality Assurance

High-Tier Escalations & Oversight: Personally oversee or execute highly sensitive, high-impact clinical appeals or complex multi-source drug coverage requests.

Quality Assurance Audits: Contribute to internal clinical quality audits to verify that the pharmacist team’s determination rationales are robust, accurate, and clearly documented.

Cross-Functional Collaboration: Act as a critical liaison between the pharmacist team and the Pharmacy Support Specialist (PSS) Supervisor to ensure seamless end-to-end routing from intake to final clinical decision.

Special Projects: Lead or contribute to specialized operational workstreams, client-facing implementations, and product optimization tasks as assigned.

Other duties as required.*

*This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

Requirements

• Education: Doctor of Pharmacy (PharmD) degree from an accredited institution.
• Licensure: Active, unrestricted pharmacist license in good standing in your state of residence.

PBM Experience: Minimum of 3 years of direct experience in PBM operations, managed care utilization management, or clinical prior authorization/appeals reviews.

Leadership Experience: Minimum of 1 year of experience in a formal leadership, mentorship, team lead, or instructional training capacity within a clinical environment.

Expert Communication: Masterful verbal and written communication skills, with a proven ability to deliver constructive feedback to peers and confidently navigate complex clinical discussions.

Analytical Acumen: Exceptional skills in parsing medical literature, analyzing comparative effectiveness research, and synthesizing ambiguous chart notes into concrete operational paths.

Technical Proficiency: High-level familiarity with Google Workspace and Microsoft Office products, alongside experience navigating complex clinical drug databases (e. g., Medi-Span, First Databank).

Company Standard Requirements

• Ability to work well with others in a collaborative environment
• Ability to get things done with resources you don’t control
• Willingness to admit you don’t know and ask for help
• Exhibit constant curiosity and a drive to problem solve
• Exhibit desire to learn and grow on a continuous basis