Hi, we're Oscar. We're hiring a Clinical Pharmacist Supervisor - Prior Authorization to join our Pharmacy Utilization Management team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. 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. This is an authentic Oscar Health job opportunity. 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. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.
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