Manager, Formulary & Medical Pharmacy Operations
Manager, Formulary & Medical Pharmacy Operations
Oscar Health is hiring a Manager of Formulary & Medical Pharmacy Operations to join our Pharmacy team. In this role you will oversee clinical pharmacy initiatives that drive affordability savings, manage core formulary management operations, and partner across Pharmacy, Medical Economics, and Office of Clinical Affairs to operationalize pharmacy‑related workflows.
Location: Remote. Candidates must reside in Florida. Future hybrid model could involve a hub office in local metro area.
Pay Transparency: $144,000 – $189,000 per year, plus benefits, unlimited vacation, and annual performance bonuses.
Responsibilities- Provide insights and recommendations for trend management and clinical effectiveness, including serving as a key contributor in enterprise affordability process for pharmacy.
- Manage the pipeline of enterprise affordability projects across the pharmacy department and oversee performance of active initiatives.
- Partner with leads across the organization to communicate and identify upstream and downstream impacts to the business.
- Contribute to design and implementation of clinical programs to improve patient outcomes and reduce costs (medication adherence, chronic disease management, patient education).
- Operationalize, develop, and maintain a clinically appropriate and cost‑effective formulary by managing Oscar’s P&T committee, evaluating new developments, and making recommendations on new‑to‑market drugs and new indications.
- 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, and business questions related to formulary operations.
- Maintain mental health parity NQTL responses and collaborate for future filings and audit responses.
- Ensure compliance with applicable laws and regulations.
- Perform other duties as assigned.
- Doctor of Pharmacy degree (Pharm
D). - 4+ years experience in PBM or payer 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).
- Residency training.
- Experience with Marketplace Exchange and Medicare Advantage.
Oscar is an Equal Opportunity Employer and we cultivate an inclusive environment. We support applicants with reasonable accommodations during the application process.
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