Hi, we're Oscar. Were hiring a Clinical Pharmacist to join our Pharmacy team.
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:
As a Clinical Pharmacist you will play a critical role on the Pharmacy Clinical Review Team as a reviewer of prior authorizations & appeals for Oscars Exchange line of business across all states. This role will also support review & development of new clinical guidelines & serve as an internal pharmacy SME for other teams within Oscar.
You will report to the Manager of Clinical Pharmacy.
- Review & render decisions on authorizations & appeals for specialty, non-specialty, & physician administered drugs
- Conduct peer-to-peer calls with prescribers to discuss the clinical rationale of adverse determinations
- Participate in clinical quality audits (inter-rater reliability testing)
- Provide internal team support for escalations & questions from pharmacy technicians & physicians
- Develop & review clinical criteria
- 3+ years of experience in managed care performing clinical review/utilization management.
- Active, unrestricted California pharmacist license
- Doctor of Pharmacy Degree
- Willingness to obtain licensure/training with new states, as needed
- Strong clinical skills & experience applying clinical criteria in clinical review setting
- Ability to obtain & maintain secure, high-speed & consistent internet connectivity
- 5+ years of experience performing clinical review & experience writing clinical criteria
- Board Certification (i.e. BCPS, BCOP)
- Residency training
- Experience practicing pharmacy in a clinical setting (i.e. retail, hospital, specialty, etc.)
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 (email@example.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.
COVID-19 vaccine requirements for in-person work:
To protect the health & safety of our employees, we require any employee conducting in-person work* to be fully vaccinated against COVID-19 by their start date.
If you are unable to be vaccinated due to medical or protected religious reasons, please reach out to our Benefits team at firstname.lastname@example.org to submit an accommodations request.
*Note: In-person work includes: employees required to work from our offices (either full-time or part-time), employees conducting sales work in the field & employees conducting at-home or in-person visits with members.