Key skills

Pharmacy Benefit Management (PBM)Healthcare data reviewChange managementHealth insurance regulation complianceTechnical team collaborationSystems integrationProduct managementMedical payer claims adjudication systemsPharmacy claim testingQuality Assurance (QA)Ticketing systems JiraTicketing systems AppianProject Management systems (Monday.com)JiraProject ManagementChange ManagementProduct Management

About this role

Oscar Health is a health insurance company focused on serving its members through a technology platform. The Project Manager- Pharmacy Associate will support program implementations and operational improvements, ensuring efficiency and effectiveness while managing relationships with stakeholders.

Responsibilities:

Organize and support daily activities based on the goals of the program
Identify optimization opportunities to support program objectives
Support implementations end to end to ensure success
Lead certain components of the program
Partner with other departments and various stakeholders to ensure operational excellence
Support a successful program end to end through assisting in project plan development, keeping your stakeholders in the loop on status, proactively flagging, managing escalations, tracking and helping to resolve program risks and milestones, and supporting program retros to assess strengths and weaknesses
Support the tracking and monitoring of controls
Develop tools and standards to support team programs year over year based on program retros
Develop meeting materials, track and follow-up on action items, assist with management of all project plans
Compliance with all applicable laws and regulations
Other duties as assigned

Requirements:

Bachelor's degree or 4 years commensurate experience
3+ years working for a PBM, Payer, or Pharmacy Consulting firm, with a focus on reviewing healthcare data
3+ years leading cross-functional teams/projects and change management
1+ years working with health insurance regulation/compliance
1+ years working with technical teams, integrations or product management
Experience with medical payer and PBM claims adjudication systems, such as RxClaim
Experience with pharmacy claim testing and Quality Assurance (QA)
Experience with a ticketing system (such as Jira or Appian)
Experience with Project Management systems (such as Monday.com)
Experience with payers offering ACA/health exchange insurance