Manager of Formulary and Pharmacy Operations

Oscar is a pioneering health insurance company driven by technology and dedicated to serving our members with a family-like care approach. Since 2012, our mission has been to create the ideal health insurance solution that prioritizes member experience.

About the Role :

As the Manager of Formulary and Pharmacy Operations, you will lead clinical pharmacy initiatives aimed at cost savings while managing core formulary operations. Collaborate with teams across Pharmacy, Medical Economics, and Clinical Affairs to implement effective pharmacy workflows and monitor ongoing cost-saving initiatives related to both pharmacy and medical benefits.

This role is fully remote, available for candidates in the Pittsburgh, PA area. While currently remote, future work models may include a hybrid approach depending on organizational needs.

Compensation : The base pay for this role ranges from $144,000 to $189,000 annually. Employees are also eligible for benefits, unlimited vacation, and annual performance bonuses.

Your Responsibilities :

• Provide insights for managing trends and ensuring clinical effectiveness, contributing to the affordability process for pharmacy.
• Manage the pipeline of projects within the pharmacy department, overseeing the performance of active affordability initiatives.
• Work alongside organizational leaders to identify impacts to the business and communicate necessary information.
• Help design and implement clinical programs focused on enhancing patient outcomes and minimizing costs.
• Programs may include initiatives for medication adherence, chronic disease management, and patient education.
• Develop and maintain a cost-effective formulary by managing Oscar's P&T committee, evaluating new developments in drug treatments, and recommending strategies for new drugs and indications.
• Optimize medical pharmacy preferred drug lists and strategies to promote the use of cost-efficient infusion products.
• Provide comprehensive written recommendations for regulatory inquiries and other business-related questions regarding formulary operations.
• Ensure compliance with mental health parity laws and manage cross-functional efforts for future filings in response to audits.
• Maintain adherence to all applicable laws and regulations, along with other duties as assigned.

Requirements :

Bonus Qualifications :

At Oscar, we value diversity and are committed to creating an inclusive environment that allows everyone to be their authentic selves and feel supported. We aim to transform healthcare by embracing unique perspectives and backgrounds.

Final offer amounts will be based on individual skills, qualifications, and experience. Full-time employees are entitled to benefits including medical, dental, and vision coverage, paid holidays, sick leave, parental leave, 401(k) plan access, life and disability insurance, and wellness reimbursements.

Oscar promotes accessibility in hiring and encourages applicants requiring accommodations during the application process to reach out to the Oscar Benefits Team. For more detailed information on how we handle applicants' personal information, please review our Privacy Policy.