Prior Authorization Pharmacist

Summary

Join Oscar's Pharmacy team as a Prior Authorization Pharmacist to review prior authorizations, report to the Clinical Pharmacist Team Lead, and work in a blended culture with remote or work-from-home options.

Requirements

• 3+ years of experience as a licensed pharmacist
• Active, unrestricted pharmacist license
• Doctor of Pharmacy Degree
• Willingness to obtain licensure/training with new states

Responsibilities

• Review and render decisions on authorizations and appeals for specialty, non-specialty, and physician administered drugs
• Conduct peer-to-peer calls with prescribers to discuss the clinical rationale of adverse determinations
• Participate in clinical quality audits and inter-rater reliability testing
• Provide internal team support for escalations and questions
• Apply clinical expertise to ensure appropriate and safe use of pharmaceuticals by members and providers
• Compliance with all applicable laws and regulations

Benefits

• 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