Manager, Clinical Pharmacy Programs
Hi, we're Oscar. We're hiring a Manager of Clinical Pharmacy Programs to join our Pharmacy team.
Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.
About the role
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. #LI-Hybrid
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.
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)
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At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.
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.
Artificial Intelligence (AI) Guidelines: Please see our AI Guidelines for the acceptable use of artificial intelligence during the interview process at Oscar.
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.
Perks and Benefits
Health and Wellness
- Pet Insurance
- Mental Health Benefits
- FSA
- HSA
- Fitness Subsidies
- Health Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- Short-Term Disability
- Long-Term Disability
Parental Benefits
- Adoption Leave
- Fertility Benefits
- Family Support Resources
- Non-Birth Parent or Paternity Leave
- Birth Parent or Maternity Leave
- Return-to-Work Program
Work Flexibility
- Remote Work Opportunities
- Flexible Work Hours
- Hybrid Work Opportunities
Office Life and Perks
- Happy Hours
- Commuter Benefits Program
- Casual Dress
- Snacks
Vacation and Time Off
- Personal/Sick Days
- Paid Holidays
- Paid Vacation
Financial and Retirement
- Company Equity
- Performance Bonus
- Financial Counseling
- 401(K) With Company Matching
Professional Development
- Internship Program
- Leadership Training Program
- Access to Online Courses
- Mentor Program
Diversity and Inclusion
- Employee Resource Groups (ERG)
- Diversity, Equity, and Inclusion Program
Company Videos
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