[Hiring] Prior Authorization Pharmacist @Oscar Health

Role Description

Hi, we're Oscar. We're hiring a Prior Authorization Pharmacist to join our Pharmacy Team. 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
• 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 - 146,711.25 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

Requirements

• 3+ years of experience as a licensed pharmacist
• 2+ years of experience performing prior authorization review in a managed care setting
• Active, unrestricted pharmacist license
• Doctor of Pharmacy Degree
• Willingness to obtain licensure/training with new states

Bonus Points

• Clinical experience applying clinical criteria in clinical review setting
• Board Certification (i.e. BCPS, BCOP)
• Residency training
• Experience practicing pharmacy in a clinical setting (i.e. retail, hospital, and specialty)

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