Hi, were Oscar. Were a fully licensed health insurer. Our goal is to make healthcare simple, transparent, & human. We are changing how health insurance works by creating a healthcare experience thats intuitive & puts people, not cost or workflows, first. Were using a consumer-focused & tech-driven approach to do so. This positions us uniquely in the space - & creates one of the biggest opportunities in healthcare.
We brought together leaders from top technology, service & healthcare companies to deliver on our promise & seize this opportunity. We all work side by side in a collaborative, energetic, & creative environment. The result: better people, better ideas, & better healthcare.
In this role, you will play an essential role on our Pharmacy Team supporting all formulary management operations including initial formulary development, ongoing formulary management, & coordinating Oscars Pharmacy & Therapeutics Committee
Deliverables: What you have to achieve
As a Formulary Coordinator, youll be responsible for:
- Partnering with Pharmacy, Data Science, & our Pharmacy Benefits Manager (PBM) to identify formulary change opportunities that meet member access needs & support utilization of lowest net cost drug options
- Managing operations of Oscars P&T Committee including: scheduling drug class reviews, reviewing new branded agents, coordinating internal/external membership, documenting P&T minutes, & preparing & organizing P&T files
- Maintaining compliance with regulatory & NCQA standards & updating formulary operations to reflect changes in these requirements.
- Partnering with Oscars PBM to communicate P&T decisions for configuration & effectuation
- Maintaining updated formulary files for all markets & lines of business & conducting quality assurance to ensure file accuracy
- Support annual regulatory filings related to formulary benefits design
Winning factors: What leads to success
Were looking for someone with 5+ years of work experience in managed care supporting formulary operations or related pharmacy functions. Must-have qualifications & expertise include:
- 5+ years of relevant pharmacy managed care experience
- Acute attention to detail
- Excellent written & verbal communication skills
- Strong problem-solving skills & comfort with learning new technologies
- Excited about building new tools & thinking outside the box
We think it will make a big (positive) difference if you have:
- Experience in formulary management at an insurance company or Pharmacy Benefits Manager
- Familiarity & comfort with pharmaceuticals, either through education (PharmD, RPh) or experience at pharmaceutical manufacturers, pharmacy benefit managers, or in a clinical pharmacy setting.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we work to cultivate an environment where exceptional people can be their most authentic selves & find both belonging & support. We're on a mission to change healthcare -- 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's Pay Transparency Policy 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.