Remote Pharmacy Policy Development Associate

Summary

Join Oscar's Clinical Policy team as an Associate, Pharmacy Policy Development! You'll play a vital role in developing and reviewing pharmaceutical and medical drug policies based on current clinical evidence and national standards. This position requires a PharmD degree, active pharmacist license, and 3+ years of experience in clinical research, policy development, or medical writing. You'll work closely with the Pharmacy Operations team, ensuring our members receive high-quality care. The role offers a competitive salary, benefits, unlimited vacation, and performance bonuses. While based in NYC, Tempe, or LA, this role offers a blended work culture with remote options. Oscar is committed to diversity and inclusion, fostering a supportive and authentic work environment.

Requirements

• PharmD degree
• Active, unrestricted pharmacist license
• 3+ years of experience with clinical research, policy development, and/or medical writing
• 3+ years of experience reviewing prior authorizations
• 3+ years of experience communicating, both written and verbally, across all levels of stakeholder
• 3+ years of experience using Excel

Responsibilities

• Review, develop, and amend our policies referencing standards of care, third party criteria, and other sources to ensure they support the most up to date standards, working in close partnership with our Pharmacy Operations team
• Track edits, amendments, evidence submissions and feedback in accordance with Clinical Policy operational standards
• Track evidence submissions and feedback on policies, and prioritize policy updates
• Develop an in-depth understanding of regulatory and quality requirements applicable to our programs
• Ensure processes and documentation are in place and in compliance with State, Federal and NCQA requirements
• Provide support on regulatory audits and quality accreditation surveys, as needed
• Compliance with all applicable laws and regulations
• Other duties as assigned

Preferred Qualifications

• Experience working with the CVS portal and criteria, or with MCG
• Experience working in a fast-paced, collaborative environment
• Medical coding experience and/or certification
• Regulatory or compliance experience
• Experience working in a fast-paced, collaborative environment
• Residency training completed from an accredited ASHP or AMCP program

Benefits

• Employee benefits
• Participation in Oscar's unlimited vacation program
• Annual performance bonuses
• Medical, dental, and vision benefits
• 11 paid holidays
• Paid sick time
• Paid parental leave
• 401(k) plan participation
• Life and disability insurance
• Paid wellness time and reimbursements