Oscar Health
Manager, Clinical Pharmacy Programs
Oscar Health, Los Angeles, California, United States, 90079
Overview
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Manager, Clinical Pharmacy Programs
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Oscar Health . The Manager, Pharmacy Clinical Programs oversees and manages clinical pharmacy programs driving affordability savings, including core formulary management operations. This role partners across Pharmacy, Medical Economics, and the Office of Clinical Affairs to operationalize pharmacy-related workflows and monitor existing savings plans for drugs on both the pharmacy and medical benefits. You will report to the Senior Director, Pharmacy Clinical Operations. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. This is a hybrid role in our Arizona, New York and California office. You will work part of the time in the office and part of the time remote / work-from-home. Pay Transparency: The base pay for this role is: $144,000 - $189,000 per year. You are also eligible for employee benefits, participation in Oscar\'s unlimited vacation program and annual performance bonuses. Other notes: This is an authentic Oscar Health job opportunity. Oscar offers equal opportunity employment and a benefits program for full-time employees. 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 reducing costs These programs may include 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 supports 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 Qualifications
Doctor of Pharmacy degree (PharmD) 4+ years working for 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 This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
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Join to apply for the
Manager, Clinical Pharmacy Programs
role at
Oscar Health . The Manager, Pharmacy Clinical Programs oversees and manages clinical pharmacy programs driving affordability savings, including core formulary management operations. This role partners across Pharmacy, Medical Economics, and the Office of Clinical Affairs to operationalize pharmacy-related workflows and monitor existing savings plans for drugs on both the pharmacy and medical benefits. You will report to the Senior Director, Pharmacy Clinical Operations. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. This is a hybrid role in our Arizona, New York and California office. You will work part of the time in the office and part of the time remote / work-from-home. Pay Transparency: The base pay for this role is: $144,000 - $189,000 per year. You are also eligible for employee benefits, participation in Oscar\'s unlimited vacation program and annual performance bonuses. Other notes: This is an authentic Oscar Health job opportunity. Oscar offers equal opportunity employment and a benefits program for full-time employees. 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 reducing costs These programs may include 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 supports 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 Qualifications
Doctor of Pharmacy degree (PharmD) 4+ years working for 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 This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
#J-18808-Ljbffr