Hi, we're Oscar. Were hiring a Pharmacy Technician to join our Clinical Review team in our Manhattan office.
Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 & headquartered in New York City. Our goal is to make health insurance simple, transparent, & human. We need your help to do so.
About the role:
You will play an essential role in building our pharmacy utilization management function. The Clinical Review team is one of Oscars most important clinical functions - we encourage evidence-based practice through utilization review to ensure our members get access to the right care - particularly those who need it most.
You will be responsible for understanding & helping to grow our pharmacy utilization management program & driving high quality reviews. Also providing support on regulatory audits & quality accreditation surveys, as needed & supporting the team prepare for expansion into new markets.
You will report into the Pharmacy Clinical Review Team Lead.
Determining eligibility & screening incoming pharmacy prior authorization requests for all required documents
Preparing, organizing, & distributing pharmacy prior authorization requests for review by pharmacist/physician & responding to pharmacist/physician requests for additional information
Learning & using Oscar & vendor tools to create, process, & properly track pharmacy prior authorization requests
Collecting relevant medical information (via telephone, fax, & portal) & applying the appropriate PA criteria
Clearly documenting all communication & decision-making, ensuring a peer could easily reference & understand your decision
1+ years of performing pharmacy reviews for a managed care plan or pharmacy benefits manager
Active, unrestricted Pharmacy Technician certification (CPhT)
In-depth understanding of how to operationalize step therapy rules & regulations
Life at Oscar:
Our more than 1,000 employees aim to make health care affordable & accessible for all. We apply this same vision to our perks & benefits, including: medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, & volunteer opportunities.
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 & find both belonging & support. We're on a mission to change health care -- an experience made whole by your unique background & perspectives.
Oscar applicants are considered solely based on their qualifications, without regard to applicants disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (firstname.lastname@example.org) to make the need for an accommodation known.
Pay Transparency Policy
Oscar ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.