Oscar Health · 8 hours ago
Senior Manager, Network Performance
United States
Full-time
Remote
Senior Level
$148K/yr - $194K/yr
7+ years expOscar Health is a health insurance company focused on serving its members through a technology-driven platform. They are seeking a Senior Manager, Medical Economics to lead a team of analysts in identifying cost-saving opportunities and improving total cost of care through analytical collaboration and innovative financial modeling.
Health CareHealth InsuranceInsuranceInsurTech
Responsibilities
Lead team programs to identify and measure cost-saving initiatives
Provide mentorship, and development planning for team members to promote growth and learning
Maintain current knowledge of medical economics best practices, and work to drive innovation and new approaches
Develop proactive financial models to assess the potential cost and use impacts of proposed clinical programs, network strategies, and policy changes. Conduct sensitivity analyses and stress-testing on models to understand the range of potential outcomes under multiple utilization and cost scenarios
Perform in-depth analysis of integrated claims and operational data — e.g. medical, pharmacy, labs and authorizations) to identify cost and trend drivers
Design and build retrospective studies to measure the actual financial and clinical outcomes of implemented programs, comparing results against initial projections
Promote and shape best practices concerning documentation
Contribute departmental improvements in automation, AI application, and analytic tooling to increase efficiency and the sophistication of your team's work
Serve a trusted analytic business partner and advisor to stakeholders in supported functional units
Maintain relationships, rapport, and lines of communication with stakeholders
Influence and collaborate with partners to guide strategic business decisions with respect to medical expense initiatives
Compliance with all applicable laws and regulations
Other duties as assigned
Qualification
Required
Bachelor's degree in a STEM field
7+ years of relevant quantitative analysis experience
Proven experience in health insurance / payer analytics, with an understanding of medical claims data (e.g., CPT/HCPCS, ICD-10, DRGs) and standard healthcare industry data sources
Preferred
Associate or Fellow of the Society of Actuaries (SOA), or on the track to become one
Experience developing measurement of clinical intervention ROI
Knowledge of prior authorization optimization and automation
Familiarity with pharmacy economics
Background in value-based care analytics
Experience translating between clinical, business, and analytic vocabularies
Benefits
Employee benefits
Participation in Oscar's unlimited vacation program
Annual performance bonuses
Medical, dental, and vision benefits
11 paid holidays
Paid sick time
Paid parental leave
401(k) plan participation
Life and disability insurance
Paid wellness time and reimbursements
Company
Oscar Health
Oscar is a health insurance company that offers individual and family plans, medicare advantages, and small group products.
1001-5000 employees
H1B Sponsorship
Oscar Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (19)
2024 (24)
2023 (22)
2022 (36)
2021 (13)
Funding
Current Stage
Public CompanyTotal Funding
$1.99BKey Investors
Tiger Global ManagementAlphabetFounders Fund
2025-09-16Post Ipo Debt· $355M
2021-03-03IPO
2020-12-17Private Equity· $140M
Leadership Team
Mark Bertolini
Chief Executive Officer
Steven B. Kelmar
Executive Vice President & COS
Recent News
2026-01-17
2026-01-16
2026-01-16
Company data provided by crunchbase