About this role
Role Overview
- Review and render decisions on authorizations and appeals for specialty, non-specialty, and physician administered drugs
- Conduct peer-to-peer calls with prescribers to discuss the clinical rationale of adverse determinations
- Participate in clinical quality audits and inter-rater reliability testing
- Provide internal team support for escalations and questions
- Apply clinical expertise to ensure appropriate and safe use of pharmaceuticals by members and providers.
- Compliance with all applicable laws and regulations
- Other duties as assigned
Requirements
- 3+ years of experience as a licensed pharmacist
- 2+ years of experience performing prior authorization review in a managed care setting
- Active, unrestricted pharmacist license
- Doctor of Pharmacy Degree
- Willingness to obtain licensure/training with new states
Benefits
- employee benefits
- participation in Oscar's unlimited vacation program
- annual performance bonuses