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Oscar Health // health insurance
 
Tempe, Arizona, United States    Posted: Tuesday, August 25, 2020
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. Were hiring a Team Lead to join our Pharmacy  team in our Tempe 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 helping build our pharmacy utilization management function & leading the pharmacy processors. We encourage evidence-based practice through utilization review to ensure our members get access to the right care - particularly those who need it most. Your job will be to set the pharmacy processors up for success in their day to day jobs. You will set targets, communicate vitals & prioritization, & clear obstacles preventing processors from achieving targets each day. 

 As a Pharmacy Team Lead, we expect you to be dedicated to high quality pharmacy decision-making & improving the member & provider experience.

You will report into the Senior Manager of Clinical Operations.

You will:

  • Developed a comprehensive understanding of the Clinical Review pharmacy processes & additional processes that are needed to improve consistency & quality.

  • An in depth understanding of determining eligibility & screening incoming pharmacy prior authorization requests for all required documents

  • Begun to form strong working relationships with internal & external stakeholders

  • Created resources to support the team of processors grow in their content knowledge & problem solving skills

  • Become an inhouse expert on all Clinical Review pharmacy related matters to answer questions on the scope & workflows

  • Make sure our day-to-day processes are executed in a timely & accurate manner.

  • Develop existing team members to take on new processes

  • Support the processor team by identifying issues & presenting resolutions

  • Contribute to team wide goals to improve Clinical Review processes & integrate additional functions into our daily operations

  • Participate in quality improvement activities as requested

  • Develop a working familiarity with applicable regulatory & accreditation requirements

  • Provide support on regulatory audits & quality accreditation surveys, as needed

  • Support the team prepare for expansion into new markets, as needed.

About you:

  • Three (3) years of experience leading processing team and/or performing pharmacy reviews for a managed care plan or pharmacy benefits manager

  • Three (3) years of managing a team

  • Strong verbal & written communications, & interpersonal interactions (e.g., partnering, conflict management, consulting)

Bonus points:

  • Bachelors degree

  • Active, unrestricted Pharmacy Technician certification (CPhT)

  • Experience working with Caremarks portal & criteria

  • Experience working in a retail pharmacy

  • Experience manipulating & entering accurate data in a production driven environment


 

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.

Reasonable Accommodation

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 (accommodations@hioscar.com) 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.

 
 
 
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