[Hiring] Clinical Pharmacist @Oscar Health

Role Description

This role serves as a reviewer of prior authorizations. You will report into the Clinical Pharmacist Supervisor.

Work Location:

• This is a remote position, open to candidates who reside in: Alabama; Arizona; Arkansas; Colorado; Connecticut; District of Columbia; Florida; Georgia; Idaho; Illinois; Indiana; Iowa; Kansas; Kentucky; Maine; Maryland; Massachusetts; Michigan; Minnesota; Missouri; Nevada; New Hampshire; New Jersey; New Mexico; North Carolina; Ohio; Oregon; Pennsylvania; Rhode Island; South Carolina; Tennessee; Texas; Utah; Vermont; or Virginia.
• While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.

Pay Transparency:

• The base pay for this role is: $111,780 - $146,711 per year.
• You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

Responsibilities:

• Review and render decisions on authorizations and appeals for specialty, non-specialty, and physician administered drugs.
• Conduct peer-to-peer calls with prescribers to discuss the clinical rationale of adverse determinations.
• Participate in clinical quality audits and inter-rater reliability testing.
• Provide internal team support for escalations and questions.
• Apply clinical expertise to ensure appropriate and safe use of pharmaceuticals by members and providers.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Qualifications

• 3+ years of experience as a licensed pharmacist.
• Active, unrestricted pharmacist license.
• Doctor of Pharmacy Degree.
• Willingness to obtain licensure/training with new states, as needed.

Requirements

• 3+ years of experience performing clinical review in a managed care setting and experience writing clinical criteria (bonus points).
• Strong clinical skills and experience applying clinical criteria in clinical review setting (bonus points).
• Board Certification (i.e. BCPS, BCOP) (bonus points).
• Residency training (bonus points).
• Experience practicing pharmacy in a clinical setting (i.e. retail, hospital, specialty, etc.) (bonus points).

Benefits

• Medical, dental, and vision benefits.
• 11 paid holidays.
• Paid sick time.
• Paid parental leave.
• 401(k) plan participation.
• Life and disability insurance.
• Paid wellness time and reimbursements.