Remote Prior Authorization Pharmacist: Clinical Review

Oscar; United States; Remote; USD 112,000 - 147,000; Full time

Benefits offered by this job

Unlimited vacation

Annual performance bonus

Job summary

Oscar Health is seeking a Prior Authorization Pharmacist to join our Pharmacy Team. This remote role supports authorizations for specialty, non-specialty, and physician-administered drugs from home.

You will review decisions, conduct peer-to-peer discussions with prescribers, and participate in clinical quality audits, reporting to the Clinical Pharmacist Supervisor. US licensure and 3+ years of pharmacist experience are required.

Qualifications

• Licensed pharmacist with active license in the United States.
• 2+ years of prior authorization review experience in managed care or similar setting.
• Strong understanding of clinical criteria and pharmacotherapy.

Responsibilities

• Review and render decisions on prior authorizations for various drug categories.
• Conduct peer-to-peer discussions with prescribers to explain determinations.
• Participate in clinical quality audits and inter-rater reliability checks.

Skills

Licensed Pharmacist

Prior Authorization

Clinical review

Team collaboration

Education

Doctor of Pharmacy (Pharm.D.)

Tools

Clinical guidelines

Job description

Oscar Health is seeking a Prior Authorization Pharmacist to join our Pharmacy Team. This remote role supports authorizations for specialty, non-specialty, and physician-administered drugs from home.

You will review decisions, conduct peer-to-peer discussions with prescribers, and participate in clinical quality audits, reporting to the Clinical Pharmacist Supervisor. US licensure and 3+ years of pharmacist experience are required.