Manager, Formulary & Medical Pharmacy Operations at Oscar Health

Hi were Oscar. Were hiring a Manager Formulary & Medical Pharmacy Operations to join our Pharmacy team.Oscar is the first health insurance company built around a full stack technology platform and a relentless 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 and manage clinical pharmacy initiatives driving affordability savings including core formulary management operations. You will partner across Pharmacy Medical Economics and the Office of Clinical Affairs to operationalize pharmacy related workflows and monitor existing savings initiatives for drugs on both the pharmacy and medical benefits.You will report to the Senior Manager Formulary Operations and Pharmacy Utilization Management.Work Location: This is a remote position open to candidates who reside in: Minneapolis MN area. You will be fully remote; however our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-RemotePay 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:Provide insights and recommendations for trend management and clinical effectiveness including serving as a key contributor in the enterprise affordability process for pharmacyManage the pipeline of enterprise affordability projects across the pharmacy department (program operations and clinical) and oversee the performance of active initiativesPartner with leads across the organization as necessary in order to communicate understand and identify upstream and downstream impacts to the businessContribute to the design and implementation of clinical programs focused on improving patient outcomes and reducing costs.These programs may include medication adherence initiatives chronic disease management programs and patient education effortsOperationalize develop and maintain a clinically appropriate and cost-effective formulary 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 drugs and new drug indications.Oversee and optimize medical pharmacy preferred drug lists and strategies to supports utilization of lowest unit cost infusion productsProvide written recommendations with responses and corresponding documentation for regulatory inquiries feedback on future legislation and other business questions that probe at formulary operations.Accountable and responsible for maintaining mental health parity NQTL responses and working cross-functionally for future filings and responding to ongoing objections during the audit process.Compliance with all applicable laws and regulationsOther duties as assignedRequirements:Doctor of Pharmacy degree (PharmD)4 years working for PBM or Payer in clinical pharmacy operations4 years leading cross-functional teams/projects and change management3 years supporting formulary management (P&T Committee clinical policy development formulary run operations)Bonus points:Residency TrainingExperience with Marketplace ExchangeThis 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 discrimination-free 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. Full-time 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.Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.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.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 .Required Experience:Manager Key Skills IT Experience,LTC Pharmacy,Hospital Experience,Pharmacy Software,Infusion Experience,Management Experience,Pharmacy Residency,Training & Development,Pharmacy Technician Experience,Supervising Experience,Clinical Pharmacy Experience,Compounding Medications Employment Type : Full-Time Experience: years Vacancy: 1 Yearly Salary Salary: 144000 - 189000