Senior Manager, Utilization Management Strategy & Operations

    • New York, NY

Hi, we're Oscar. We’re hiring a Senior Manager, Utilization Management Strategy & Operations to join our Clinical Operations team in our New York office. 

Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, transparent, and human. We need your help to do so.

About the role:

As a Senior Manager, you will use your expertise to take ownership of the day-to-day strategy and design for our medical Utilization Management processes. You will drive the development of processes and technology/systems improvements as well as facilitate cross-functional support where needed to implement strategic improvements for our operations. In addition, you will play a large role in troubleshooting any issues that arise by investigating the scope, cause and scale of the problem and driving towards solutions. You may also interact closely with regulatory authorities as well as Oscar’s external vendors.

You will report into the Associate Director, Clinical Operations.

Responsibilities:

  • Partner with Oscar leadership to develop the short- and long-term strategies and operational priorities for our team
  • Serve as the primary day-to-day partner with our Product/Engineering team to prioritize, develop and implement improvements to existing workflows 
  • Surface data, process, and technology issues through proactive identification, measurement, and monitoring of our operations
  • Continually refine operational processes to ensure compliance and scalability
  • Lead the development and documentation of workflows and operating procedures 
  • Partner with our Legal and Compliance teams to lead policy and procedure clarification, stay up to date on operational policies, and ensure our operations are compliant with all regulatory and quality requirements
  • Manage and maintain relationships with relevant Oscar business leads
  • Oversee the maintenance and accuracy of several team tools, including letter templates, desktop resources, and regular reporting
  • Become the go-to individual at the company for Utilization Management operations

Requirements:

  • A bachelor’s degree
  • 7+  years of professional experience in roles with a focus on operations, implementation, and/or process management/improvement
  • 3+ years managing direct reports and overseeing large-scale cross-functional project initiatives
  • Experience in health care, utilization management and/or insurance operations
  • Knowledge of CMS, regulatory, and/or accreditation requirements
  • Experience leveraging technology in creative/novel ways to solve problems

Life at Oscar: 

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.

We encourage our members to care for their whole selves, and we encourage our employees to do the same with comprehensive medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, and volunteer opportunities.

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 (accommodations@hioscar.com) to make the need for an accommodation known.

Pay Transparency Policy:

Oscar ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.


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