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Associate Director, Formulary Design and Strategy

Oscar Health New York ,NY
  • Posted: over a month ago
  • Full-Time
Job Description

Hi, we're Oscar. We're hiring an Associate Director for Formulary Design and Strategy to join our Clinical team in our New York City office.

Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, transparent, and human. We need your help to do so.

About this role:

In this role, you will play an essential role on our Pharmacy Team supporting all formulary management operations including initial formulary development, ongoing formulary management, and coordinating Oscar's Pharmacy & Therapeutics Committee

Deliverables: What you have to achieve

  • Partner with Pharmacy, Data Science, and our Pharmacy Benefits Manager (PBM) to identify formulary change opportunities that meet member access needs and help use lowest net cost drug options
  • Manage operations of Oscar's P&T Committee including: scheduling drug class reviews, reviewing new branded agents, coordinating internal/external membership, documenting P&T minutes, and preparing and organizing P&T files
  • Comply with regulatory and NCQA standards and updating formulary operations to reflect changes in these requirements. 
  • Partner with Oscar's PBM to communicate P&T decisions for configuration and effectuation
  • Maintaining updated formulary files for all markets and lines of business and conducting quality assurance to ensure file accuracy 
  • Support annual regulatory filings related to formulary benefits design

What leads to success

We're looking for someone with 5+ years of work experience. Must-have qualifications and expertise include:

  • Interest in rapidly learning a new vocabulary of pharmaceutical compounds and insurance functions. 
  • You are excited about navigating complex situations, and improving processes
  • Comfort with learning new technologies
  • Excited about building new tools

We think it will make a big (positive) difference if you have:

  • Experience in formulary management at an insurance company or Pharmacy Benefits Manager
  • Familiarity and comfort with pharmaceuticals, either through education (PharmD, RPh) or experience at pharmaceutical manufacturers, pharmacy benefit managers, or in a clinical pharmacy setting.

Life at Oscar:

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. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

We encourage our members to care for their whole selves, and we encourage our employees to do the same with comprehensive medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, and volunteer opportunities.

Reasonable Accommodation

Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

Pay Transparency Policy

Oscar ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.

Company Description
Founded in 2012, Oscar was the first direct-to-consumer health insurer, pairing member engagement with our own full-stack technology. Since we began serving members in our first market in 2014, we’ve made great progress against our mission of creating a simpler and more affordable health insurance experience for more people across the U.S.

We’ve released products like our telemedicine service and our Care Teams. We launched our Oscar for Providers platform, and then our Small Group business and Medicare Advantage business lines. Last year, we announced our biggest market expansion ever – and 2021 will mark the fourth consecutive year Oscar expands its national footprint.

Oscar Health

Founded in 2012, Oscar was the first direct-to-consumer health insurer, pairing member engagement with our own full-stack technology. Since we began serving members in our first market in 2014, we’ve made great progress against our mission of creating a simpler and more affordable health insurance experience for more people across the U.S. We’ve released products like our telemedicine service and our Care Teams. We launched our Oscar for Providers platform, and then our Small Group business and Medicare Advantage business lines. Last year, we announced our biggest market expansion ever – and 2021 will mark the fourth consecutive year Oscar expands its national footprint.

Address

New York, NY
USA

Website

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