Hi, we're Oscar. We're hiring a Manager, Formulary & Medical Pharmacy Operations to join our Pharmacy team.

Oscar is the first health insurance company built around a full stack technology platform & a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family.

About the role:

You will oversee & manage clinical pharmacy initiatives driving affordability savings including core formulary management operations. You will partner across Pharmacy, Medical Economics, & the Office of Clinical Affairs to operationalize pharmacy related workflows & monitor existing savings initiatives for drugs on both the pharmacy & medical benefits.

You will report to the Senior Manager, Formulary Operations & Pharmacy Utilization Management.

Work Location: This is a remote position, open to candidates who reside in: Florida. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

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 & annual performance bonuses.

Responsibilities:

• Provide insights & recommendations for trend management & clinical effectiveness, including serving as a key contributor in the enterprise affordability process for pharmacy
• Manage the pipeline of enterprise affordability projects across the pharmacy department (program operations & clinical) & oversee the performance of active initiatives
• Partner with leads across the organization as necessary in order to communicate, understand & identify upstream & downstream impacts to the business
• Contribute to the design & implementation of clinical programs focused on improving patient outcomes & reducing costs.
• These programs may include medication adherence initiatives, chronic disease management programs, & patient education efforts
• Operationalize, develop & maintain a clinically appropriate & cost-effective formulary by operating & managing Oscar's P&T committee, which includes evaluating new developments in the drug treatment landscape & providing recommendations on how to manage new to market drugs & new drug indications.
• Oversee & optimize medical pharmacy preferred drug lists & strategies to supports utilization of lowest unit cost infusion products
• Provide written recommendations with responses & corresponding documentation for regulatory inquiries, feedback on future legislation, & other business questions that probe at formulary operations.
• Accountable & responsible for maintaining mental health parity NQTL responses & working cross-functionally for future filings & responding to ongoing objections during the audit process.
• Compliance with all applicable laws & regulations
• Other duties as assigned

Requirements:

• Doctor of Pharmacy degree (PharmD)
• 4+ years working for PBM or Payer in clinical pharmacy operations
• 4+ years leading cross-functional teams/projects & change management
• 3+ years supporting formulary management (P&T Committee, clinical policy development, formulary run operations)

Bonus points:

• Residency Training
• Experience with Marketplace Exchange