Manager Formulary Operations
Manager Formulary Operations
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Job Description
Hi were Oscar. Were hiring a Manager Formulary Operations to join our team.
Oscar is the first health insurance company built around a full stack technology platform and a 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 internally formulary management operations and ensuring that appropriate oversight is in place where formulary management is delegated to a thirdparty. You will partners with the Sr. Manager to monitor the existing formulary operations and strategize future changes. You will also partners with internal stakeholders to execute on run tasks for maintenance of business operations of the existing formulary.
You will report to the Sr. Manage Formulary Operations.
Work Location:
Oscar is a blended work culture where everyone regardless of work type or location feels connected to their teammates our culture and our mission.
If you live within commutable distance to our New York City office (in Hudson Square) our Tempe office (off the 101 at University Dr) or our Los Angeles office (in Marina Del Rey) you will be expected to come into the office at least two days each week. Otherwise this is a remote / workfromhome role.
You must reside in one of the following states: Alabama Arizona Arkansas California Colorado Connecticut Florida Georgia Illinois Indiana Iowa Kansas Kentucky Maine Maryland Massachusetts Michigan Minnesota Missouri Nevada New Hampshire New Jersey New Mexico New York North Carolina Ohio Oregon Pennsylvania Rhode Island South Carolina Tennessee Texas Utah Vermont Virginia Washington or Washington D.C. Note this list of states is subject to change. #LIRemote
Pay Transparency:
The base pay for this role is: $144000 $189000 per year. You are also eligible for employee benefits participation in Oscars unlimited vacation program and annual performance bonuses.
Responsibilities
- This role is accountable for: ensuring clinical quality standards are met by maintaining clinical policies used for decisionmaking; ensure that compliance standards set by regulators and NCQA are defined in policies that procedures are documented and that those processes audited.
- Operationalize develop and maintain a clinically appropriate and costeffective formulary and medical benefit preferred drug list by operating and managing Oscars P&T committee which includes evaluating new developments in the drug treatment landscape and providing recommendations on how to manage new to market and new drug indications.
- Provide written recommendations with responses and corresponding documentation for regulatory inquiries feedback on future legislation and other business questions that probe at formulary operations.
- Responsible for annual formulary binder filings
- Accountable and responsible for maintaining mental health parity NQTL responses and working crossfunctionally for future filings and responding to ongoing objections during the audit process.
- Compliance with all applicable laws and regulations
- Other duties as assigned
Qualifications
- Doctor of Pharmacy degree (PharmD)
- 3 years working for PBM or Payer in clinical pharmacy operations
- 3 years leading crossfunctional teams/projects and change management
- 3 years supporting formulary management (P&T Committee clinical policy development formulary run operations)
Bonus Points
- Residency Training
- Experience with Marketplace Exchange
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
At Oscar being an Equal Opportunity Employer means more than upholding discriminationfree hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. Were on a mission to change health care an experience made whole by our unique backgrounds and perspectives.
Pay Transparency: Final offer amounts within the base pay set forth above are determined by factors including your relevant skills education and experience. Fulltime employees are eligible for benefits including: medical dental and vision benefits 11 paid holidays paid sick time paid parental leave 401(k) plan participation life and disability insurance and paid wellness time and reimbursements.
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 to make the need for an accommodation known.
Artificial Intelligence (AI) Guidelines: Please see our AI Guidelines for the acceptable use of artificial intelligence during the interview process at Oscar.
California Residents: For information about our collection use and disclosure of applicants personal information as well as applicants rights over their personal information please see our Notice to Job Applicants.
Required Experience:
Manager
Employment Type
Full-Time
