Oscar Health
Overview
We’re Oscar Health. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. Oscar started in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. We are hiring a Manager of Clinical Pharmacy Programs to join our Pharmacy team. Responsibilities
Provide insights and recommendations for trend management and clinical effectiveness, including serving as an important contributor in the enterprise affordability process for pharmacy. Manage the pipeline of enterprise affordability projects across the pharmacy department (program operations and clinical) and oversee the performance of active programs. Partner with leads across the organization to communicate, understand and identify upstream and downstream impacts to the business. Contribute to the design and implementation of clinical programs to improve patient outcomes and reduce costs. Program examples includes medication adherence programs, chronic disease management programs, and patient education efforts. Operationalize, develop and maintain a clinically appropriate and cost-effective formulary by operating and managing Oscar’s P&T committee, which includes evaluating new developments in the drug treatment landscape and providing recommendations on how to manage new to market drugs and new drug indications. Oversee and improve medical pharmacy preferred drug lists and strategies to support use of lowest unit cost infusion products. Provide written recommendations with responses and corresponding documentation for regulatory inquiries, feedback on future legislation, and other business questions that probe at formulary operations. Accountable and responsible for maintaining mental health parity NQTL responses and working cross-functionally for future filings and responding to ongoing objections during the audit process. Compliance with all applicable laws and regulations. Other duties as assigned. Requirements
Doctor of Pharmacy degree (PharmD). 4+ years working for a PBM or payer in clinical pharmacy operations. 4+ years leading teams/projects and change management. Bonus Points
Residency training. 3+ years supporting formulary management (P&T Committee, clinical policy development, formulary run operations). Experience with Marketplace Exchange and Medicare Advantage. Location
Remote position. Open to candidates residing in Atlanta, GA. Fully remote; future models could involve a hybrid presence at the hub office associated with your metro area. Pay Transparency
Base pay: $144,000 - $189,000 per year. Eligible for employee benefits, unlimited vacation program, annual performance bonuses, 401(k) plan participation, life and disability insurance, paid wellness time and reimbursements, 11 paid holidays, paid sick time, paid parental leave. Equal Opportunity Employer
Oscar is an Equal Opportunity Employer. We uphold discrimination-free hiring practices and cultivate an environment where people can be their most authentic selves, find belonging and support. We are on a mission to change health care. Reasonable Accommodation
Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents
For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Notice to Job Applicants. Job Attributes
Seniority level: Mid-Senior Employment type: Full-time Job function: Health Care Provider Industry: Insurance
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We’re Oscar Health. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. Oscar started in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. We are hiring a Manager of Clinical Pharmacy Programs to join our Pharmacy team. Responsibilities
Provide insights and recommendations for trend management and clinical effectiveness, including serving as an important contributor in the enterprise affordability process for pharmacy. Manage the pipeline of enterprise affordability projects across the pharmacy department (program operations and clinical) and oversee the performance of active programs. Partner with leads across the organization to communicate, understand and identify upstream and downstream impacts to the business. Contribute to the design and implementation of clinical programs to improve patient outcomes and reduce costs. Program examples includes medication adherence programs, chronic disease management programs, and patient education efforts. Operationalize, develop and maintain a clinically appropriate and cost-effective formulary by operating and managing Oscar’s P&T committee, which includes evaluating new developments in the drug treatment landscape and providing recommendations on how to manage new to market drugs and new drug indications. Oversee and improve medical pharmacy preferred drug lists and strategies to support use of lowest unit cost infusion products. Provide written recommendations with responses and corresponding documentation for regulatory inquiries, feedback on future legislation, and other business questions that probe at formulary operations. Accountable and responsible for maintaining mental health parity NQTL responses and working cross-functionally for future filings and responding to ongoing objections during the audit process. Compliance with all applicable laws and regulations. Other duties as assigned. Requirements
Doctor of Pharmacy degree (PharmD). 4+ years working for a PBM or payer in clinical pharmacy operations. 4+ years leading teams/projects and change management. Bonus Points
Residency training. 3+ years supporting formulary management (P&T Committee, clinical policy development, formulary run operations). Experience with Marketplace Exchange and Medicare Advantage. Location
Remote position. Open to candidates residing in Atlanta, GA. Fully remote; future models could involve a hybrid presence at the hub office associated with your metro area. Pay Transparency
Base pay: $144,000 - $189,000 per year. Eligible for employee benefits, unlimited vacation program, annual performance bonuses, 401(k) plan participation, life and disability insurance, paid wellness time and reimbursements, 11 paid holidays, paid sick time, paid parental leave. Equal Opportunity Employer
Oscar is an Equal Opportunity Employer. We uphold discrimination-free hiring practices and cultivate an environment where people can be their most authentic selves, find belonging and support. We are on a mission to change health care. Reasonable Accommodation
Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents
For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Notice to Job Applicants. Job Attributes
Seniority level: Mid-Senior Employment type: Full-time Job function: Health Care Provider Industry: Insurance
#J-18808-Ljbffr