Clinical Pharmacist Supervisor - Prior Authorization

United States·New Yorkmid

OtherSupervisor

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Quick Summary

Key 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,

Requirements Summary

Doctor of Pharmacy Degree. Active, unrestricted pharmacist license. 4+ years of experience in managed care performing clinical review/utilization management.

Technical Tools

OtherSupervisor

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

~1 min read

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.

Responsibilities

~1 min read

→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

~1 min read

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.

Nice to Have

~2 min read

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.

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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.

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