Clinical Pharmacist Supervisor - Prior Authorization

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.

Learn more about how you can safeguard yourself from recruitment fraud here . 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. Full-time employees are eligible for

Benefits

including: medical, dental, and vision

Benefits

, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their

Qualifications

, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar

Benefits

Team (a***s@***.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy . Apply directly on RemoteJobs.org: https://remotejobs.org/remote-jobs/clinical-pharmacist-supervisor-prior-authorization-oscar-health