Hi, we're Oscar. We're hiring a Clinical Pharmacist Supervisor - Prior Authorization to join our Pharmacy Utilization Management team.
About the role:The Clinical Pharmacist Supervisor - Prior Authorization oversees a team of pharmacists performing clinical review for prior authorizations and appeals. This role will drive operational excellence, foster team development, and ensure sound, evidence-based clinical decision-making to consistently meet organizational performance objectives, regulatory standards, and quality goals.
You will report into the Manager, Pharmacy Utilization Management.
Work Location: This position is fully remote and open to candidates residing in the U.S.,
excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote
Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $135,792.00 - $178,227.00 per year. The base pay for this role in all other locations is: $122,212.00 - $160,404.00 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.
Responsibilities:- Manage daily workflows, queue monitoring, and scheduling to ensure the pharmacist team consistently meets clinical accuracy standards and response timelines.
- Monitor productivity and quality metrics, providing routine 1-on-1 coaching, performance reviews, and cross-training to help team members build clinical skills, step into expanded roles, and prepare for market expansion.
- Serve as a clinical expert to review, troubleshoot, and resolve complex, high-priority prior authorization cases and appeals.
- Collaborate with the Clinical Quality team on routine reviews, using audit findings to deliver constructive coaching, training, and performance support.
- Proactively identify and implement process improvements, and resolve day-to-day challenges to keep the team operating efficiently.
- Partner with cross-functional leadership to develop, update, and organize job aids and team training resources.
- Participate in a rotated weekend and holiday on-call schedule to monitor queues and offer team support when needed.
- Compliance with all applicable laws and regulations
- Other duties as assigned
Requirements:- Doctor of Pharmacy Degree.
- Active, unrestricted pharmacist license.
- 4+ years of experience in managed care performing clinical review/utilization management.
- 1+ year(s) of people or project management experience.
Bonus points:- Experience managing a team of clinical pharmacists performing clinical review/utilization management operations.
- Experience developing and managing key performance indicators/metrics for an operational team.
- Strong clinical skills and experience applying clinical criteria in a clinical review setting.
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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.
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