Full-Time

Vice President

Trade Relations & Formulary Strategy

Updated on 9/3/2026

SmithRx

SmithRx

501-1,000 employees

PBM offering pass-through pricing model

Compensation Overview

$238k - $280k/yr

+ Bonus + Commission + Equity

North America

Remote

Bachelor's, PharmD

Category
Business & Strategy
Required Skills
Financial Modeling

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Requirements
  • At least 12 years of progressive leadership experience in PBM trade relations, pharmaceutical market access, formulary management, or related clinical strategy roles.
  • Experience across Commercial, Medicare, Medicaid, and Exchange lines of business.
  • Deep understanding of the PBM ecosystem, drug manufacturer contracting, GPO structures, and the operational differences between traditional rebate aggregators and 100% pass-through PBMs.
  • A proven track record of successfully negotiating complex rebate and value-based contracts with major pharmaceutical manufacturers.
  • A strong grasp of clinical pharmacology, drug pipelines, and evidence-based medicine to guide P&T committees and clinical criteria development.
  • Strong financial modeling skills and the ability to translate complex rebate structures into lowest-net-cost strategies.
  • A Bachelor’s degree in Business, Finance, or Healthcare Administration combined with extensive industry experience will be considered.
Responsibilities
  • Establish and maintain strategic relationships with pharmaceutical manufacturers, leading negotiations for rebates, discounts, and value-based contracts aligned with SmithRx’s financial objectives and client-transparency commitment.
  • Oversee rebate Group Purchasing Organization partnerships and administration, ensuring compliance, financial accuracy, and strategic alignment with the pass-through model.
  • Monitor pharmaceutical market dynamics, generic pipelines, and biosimilar launches to proactively position trade and contracting strategies ahead of market shifts.
  • Provide executive oversight for rebate financial modeling, market assessments, and guarantee development in partnership with Pricing and Underwriting teams.
  • Own SmithRx’s formulary strategy and ensure recommendations are grounded in clinical evidence, market intelligence, and lowest-net-cost financial modeling.
  • Lead and oversee the Pharmacy and Therapeutics/Formulary Advisory Committee, setting standards for governance, documentation, and objective decision-making rationale.
  • Partner with Sales and Customer Success teams to articulate the clinical and financial value of formulary strategies to prospective clients and benefits consultants.
  • Apply formulary management and utilization management experience across government programs, including Medicare and Medicaid.
  • Direct the development and deployment of clinical criteria for Prior Authorizations, Step Therapy, and Quantity Limits to ensure appropriate utilization, prevent waste, and optimize patient outcomes.
  • Ensure clinical criteria and utilization-management programs remain independent from manufacturer influence and prioritize patient health and employer savings over rebate qualification.
  • Collaborate with clinical leadership to design management strategies for high-cost specialty drugs, gene therapies, and orphan drugs.
  • Partner with executive peers across Pharmacy Networks, Clinical Operations, Sales, Finance, and Analytics to ensure integrated supply-chain execution.
  • Build, mentor, and scale a high-performing team of trade-relations directors, clinical pharmacists, and data analysts.
Desired Qualifications
  • A PharmD degree is highly preferred.
  • An active pharmacist license in good standing is a plus.

SmithRx operates in healthcare as a Pharmacy Benefit Manager (PBM) in San Francisco, managing prescription drug plans for self-insured employers and plan sponsors. It uses Pass Through Pricing: charging only an administrative fee and passing 100% of rebates to the plan sponsors and members. A real-time data–driven technology platform supports service delivery, enhancing transparency and efficiency. Revenue comes solely from admin fees, eliminating rebates-based conflicts of interest. A concierge service provides strong support to both members and clients. The goal is to offer transparent, cost-effective pharmacy benefits with excellent customer service, using technology to maximize value for clients and their members.

Company Size

501-1,000

Company Stage

Series C

Total Funding

$97.5M

Headquarters

San Francisco, California

Founded

2016

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Simplify Jobs

Simplify's Take

What believers are saying

  • Transcarent expanded SmithRx integration on April 24, 2026, broadening employer distribution.
  • UnitedAg added 55,000 members in October 2025, proving enterprise traction in niche plans.
  • SmithRx claims over $320M client savings in 2025, sharpening its sales pitch.

What critics are saying

  • GLP-1 employer budgets are breaking, forcing SmithRx clients to cut coverage in 2027.
  • Recent layoffs showed up in employee reviews, signaling operating pressure and service strain.
  • Express Scripts, CVS Caremark, and OptumRx still control employer renewals and pricing leverage.

What makes SmithRx unique

  • SmithRx serves 5,000+ employer clients with 1.5 million members by 2026.
  • Its pass-through model returns 100% of rebates and charges one administrative fee.
  • URAC accredited in March 2026, strengthening trust versus legacy PBMs.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Health Savings Account/Flexible Spending Account

Unlimited Paid Time Off

Paid Holidays

Wellness Program

Commuter Benefits

Parental Leave

Mental Health Support

Professional Development Budget

Growth & Insights and Company News

Headcount

6 month growth

-1%

1 year growth

-3%

2 year growth

-1%
PR Newswire
Jun 30th, 2026
SmithRx partners with Transcarent to bring real-time prescription cost intelligence into benefits navigation

SmithRx, a modern pharmacy benefits manager, has partnered with Transcarent to integrate prescription drug cost intelligence into Transcarent's WayFinding platform. The integration provides employees with real-time prescription cost estimates, pharmacy comparisons and lower-cost alternatives whilst giving employers visibility into drug spending. SmithRx's Drug Pathways Engine uses AI-powered technology to identify lower-cost medication options by analysing pricing data, plan rules and clinical criteria. The company works through directly contracted pharmacies and offers platform-based pricing, where every client receives identical pricing for medications. SmithRx reports average pharmacy benefit savings exceeding 20% and average per member per month savings of $37 across its client base. The partnership enables real-time pharmacy guidance within Transcarent's broader healthcare navigation experience, connecting medication decisions to related health resources and employer-sponsored benefits.

PR Newswire
Jun 9th, 2026
SmithRx launches partner ecosystem for sustainable GLP-1 weight management programs, cutting employer costs up to 70%

SmithRx, a modern pharmacy benefits manager, has launched a partner ecosystem to help employers deliver sustainable GLP-1 weight management programmes. The company is partnering with obesity medicine providers including 9amHealth, Calibrate, Mark Cuban Cost Plus Drugs, FlyteHealth and Form Health to access manufacturer-approved cash-pay pricing for GLP-1 medications. The initiative addresses mounting financial pressures on employers, who face high upfront costs and higher-than-expected utilisation for weight management coverage. Survey data shows some employers are uncertain about maintaining GLP-1 coverage in 2027 due to budget constraints, whilst nearly 70% of GLP-1 users cite cost as a key factor in treatment decisions. SmithRx's approach combines transparent pricing with clinical oversight, with some employers achieving up to 70% in cost savings through tailored pharmacy benefit programmes.

FinancialContent
Oct 6th, 2025
UnitedAg Partners with SmithRx to Modernize Pharmacy Benefits at Scale

UnitedAg partners with SmithRx to modernize pharmacy benefits at scale. SmithRx, a modern pharmacy benefits manager (PBM), today announced a new partnership with UnitedAg, a member-owned agricultural trade association and health plan Trust. This collaboration will provide UnitedAg's 1,200+ agricultural entities comprising over 55,000 members with a fiduciary-aligned, transparent, and more affordable pharmacy benefits solution. By partnering with SmithRx, UnitedAg is moving beyond a pass-through PBM model to embrace a solution built on radical transparency. SmithRx's platform gives clients full visibility into pharmacy spend and ensures every dollar saved goes directly back to employers and their employees. This approach empowers employers to take control of their benefits costs while offering employees the lowest-cost medications with unmatched clarity and care. "SmithRx is thrilled to partner with a forward-thinking organization like UnitedAg that shares our commitment to bring clarity and fairness to healthcare," said Jake Frenz, founder and CEO of SmithRx. "This partnership is a testament to the growing demand for a different kind of PBM - one that prioritizes people and provides real savings while delivering an exceptional member experience." "SmithRx's innovative model will not only help us manage our costs more effectively but, more importantly, will empower our members to make better decisions about their health," said Kirti Mutatkar, President and CEO of UnitedAg. "Our members are our most valuable asset, and we are dedicated to providing them with the best possible benefits." UnitedAg members now have access to the SmithRx platform, which empowers them with clear pricing and access to the lowest-cost medications. The platform's technology, including AI-driven efficiencies, delivers an award-winning member experience. This collaboration brings significant value to the plan by uniting a focus on transparency and service, making healthcare more affordable and accessible for all members. About SmithRx SmithRx is a modern PBM dedicated to reducing the cost and complexity of pharmacy benefits. The company empowers organizations of all sizes to take control of their pharmacy spend with a radically transparent, universal pass-through model, innovative cost-saving programs, and intuitive technology. Unlike legacy PBMs, SmithRx eliminates hidden fees, passes through 100% of rebates and discounts, and provides real-time prescription pricing and detailed savings reports. This gives clients the insights they need to make informed decisions and achieve meaningful savings for both their business and their employees. Experience the difference transparency, trust, and fairness can make in building a more equitable healthcare system. Learn more at www.smithrx.com. About UnitedAg UnitedAg is a member-owned agricultural trade association dedicated to providing comprehensive health benefits, fostering the next generation of agricultural leaders, and advocating for members' interests with lawmakers. Our mission is to support the sustainability and success of our members and the agricultural sector through tailored health benefits, leadership development, and legislative advocacy. Currently, we operate in California and Arizona and will soon expand to Oregon and Colorado. View source version on businesswire.com: https://www.businesswire.com/news/home/20251006154566/en/

Leads on Trees
May 15th, 2025
SmithRx Raises $60M to Transform Pharmacy

SmithRx has raised $60 million in Series C funding to revolutionize pharmacy benefits. The company aims to reduce costs and complexity for self-insured employers by developing advanced technology and expanding cost-saving programs. Operating independently from traditional insurers, SmithRx plans to use the funds to enhance its infrastructure, invest in data analytics, and launch initiatives targeting inefficiencies in pharmacy benefit management, promoting transparency and affordability.

Business Wire
Jun 27th, 2024
SmithRx Introduces New PBM Evaluation Methodology Optimized for Drug Cost Savings

SmithRx introduces new PBM Evaluation methodology optimized for drug cost savings.