Manager – Formulary Operations

Company	Oscar Health
Location	Los Angeles, CA, USA, Tempe, AZ, USA, New York, NY, USA
Salary	$144000 – $189000
Type	Full-Time
Degrees	PharmD
Experience Level	Mid Level, Senior

Doctor of Pharmacy degree (PharmD)
3+ years working for PBM or Payer in clinical pharmacy operations
3+ years leading cross-functional teams/projects and change management
3+ years supporting formulary management (P&T Committee, clinical policy development, formulary run operations)

Ensuring clinical quality standards are met by maintaining clinical policies used for decision-making; ensure that compliance standards set by regulators and NCQA are defined in policies, that procedures are documented, and that those processes audited.
Operationalize, develop and maintain a clinically appropriate and cost-effective formulary and medical benefit preferred drug list by operating and managing Oscar’s 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.
Provide written recommendations with responses and corresponding documentation for regulatory inquiries, feedback on future legislation, and other business questions that probe at formulary operations.
Responsible for annual formulary binder filings
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 regulations
Other duties as assigned