Hi, we're Oscar. Were hiring a Clinical Pharmacist to join our Pharmacy team in our New York 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 be working a queue of prior authorizations & appeals & rendering decisions to approve/deny the request.
Day will include talking with prescribers on peer to peers & will also handle questions/escalations from technicians
You will report into the Director of Pharmaceuticals.
- Completing review & renderinging decisions on authorization & appeals for specialty, non-specialty, & physician administered drugs
- Conducting peer-to-peers with prescribers who want to discuss the clinical rationale of an adverse determination
- Participating in clinical quality audits (inter-rater reliability testing)
- Providing internal team support for escalations & questions from the pharmacy technician & physician team
- Writing clinical criteria for Oscars formulary, which gets reviewed & approved through Oscars P&T Committee
- 3+ years of experience in managed care performing clinical review/utilization management
- Active, unrestricted pharmacy license
- Doctor of Pharmacy Degree
- Willingness to obtain licensure/training with new states, as needed
- 5+ years of experience performing clinical review & experience writing clinical criteria
- Board Certification (i.e. BCPS, BCOP)
- Residency training
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.