At Oscar Health, we are on a mission to change health care. We are looking for a Manager, Formulary & Medical Pharmacy Operations to oversee and manage the clinical pharmacy initiatives that drive our affordability savings, including core formulary management operations. In this role, 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.

What You'll Do

Provide insights and recommendations for trend management and clinical effectiveness, serving as a key contributor in the enterprise affordability process for pharmacy.
Manage the pipeline of enterprise affordability projects across the pharmacy department and oversee the performance of active initiatives.
Partner with leads across the organization to communicate, understand, and identify upstream and downstream business impacts.
Contribute to the design and implementation of clinical programs focused on improving patient outcomes and reducing costs.
Operationalize, develop, and maintain a clinically appropriate and cost-effective formulary by operating and managing Oscar's P&T committee, evaluating new drug developments and providing recommendations.
Oversee and optimize medical pharmacy preferred drug lists and strategies to support utilization of lowest unit cost infusion products.
Provide written recommendations and documentation for regulatory inquiries, future legislation feedback, and other formulary operations questions.
Be accountable for maintaining mental health parity NQTL responses and working cross-functionally for future filings and audit responses.
Ensure compliance with all applicable laws and regulations.

What We're Looking For

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

Nice to Have

Residency Training.
Experience with Marketplace Exchange and Medicare Advantage.

Team & Environment

You will report to the Senior Manager, Formulary Operations and Pharmacy Utilization Management.

Benefits & Compensation

Compensation range: $144,000 - $189,000 per year, plus annual performance bonuses.
Medical, dental, and vision benefits.
11 paid holidays, paid sick time, and paid parental leave.
401(k) plan participation.
Life and disability insurance.
Paid wellness time and reimbursements.
Unlimited vacation program.

Work Mode

This is a remote position. Candidates should be located in the Greater Hartford area.

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.