Remote Senior Manager, Pharmacist

Summary

Join Oscar's Formulary & Utilization Management Operations team as a Senior Manager, Pharmacist. You will oversee maintenance functions within formulary/medical pharmacy management and utilization management operations.

Requirements

• Doctor of Pharmacy degree (PharmD)
• Active, unrestricted US pharmacist license
• 5+ years of experience performing pharmacy prior authorizations or related production work
• 5+ years of experience supporting formulary operations (i.e. monograph development, clinical policy writing, P&T support)
• 3+ years in a managed care pharmacy leadership role

Responsibilities

• Annual submission of formulary binder and medical pharmacy preferred drug list (PDL) update/ expansion
• Annual review and update of pharmacy related clinical policies and formulary/UM related operational policies
• Review of new trade offers from rebate aggregators in partnership with Rx Insights to identify lowest net cost preferred drug strategies
• Ensure new to market drugs are reviewed weekly to determine coverage and utilization management rules
• Oversight of the Pharmacy & Therapeutics Committee
• Lead semi-annual updates to UM staffing model in partnership with Rx Insights and workforce management
• Maintain high performance standards for recruiting, hiring, and training new team members
• Partner with internal ops leads to optimize prior authorization tooling and other product enhancements to improve workflows and member/provider experience
• Maintain compliance with all applicable laws and regulations
• Other duties as assigned

Benefits

• Health insurance
• Retirement benefits
• Paid time off
• Remote work, flexible hours
• Life and disability insurance
• Bonuses and incentives
• Professional development opportunities
• Unlimited vacation program