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Senior Manager, Clinical Policy Development

Remote

Hi, we're Oscar. We're hiring a Senior Manager to join our Clinical Policy team.

Oscar is the first health insurance company built around a full stack technology platform and a 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 Senior Manager works regularly with cross functional leaders to ensure our policy development process is driving affordability goals. You will be responsible for the timely and accurate development of new policies that drive affordability savings in partnership with others. You will oversee a team to ensure our policy guidelines maintain the highest clinical quality standards. The Senior Manager works in partnership with multiple other teams, including pharmacy and medical UM.

You will report to the VP, Clinical Policy.

Work Location:

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.

If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.

You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

Pay Transparency:

The base pay for this role is: $131,200 - $172,200 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

Responsibilities

  • Interacts regularly with all levels of management on matters concerning several functional areas, department, and/or customers. Able to propose and work with more senior leaders on forward-thinking goals and roadmaps.
  • Drives development of new policies from a medical standpoint, works in close partnership with the pharmacy team for pipeline management.
  • Manage policy development process for both medical and pharmacy. Serve as the accountable party for the accuracy …
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Job Profile

Restrictions

Arizona California Colorado Connecticut Florida Georgia Illinois Iowa Kentucky Maine Maryland Massachusetts Michigan Minnesota Missouri Must reside in one of the following states Must reside in specified states Nevada New Hampshire New Jersey New Mexico New York North Carolina Ohio Oregon Pennsylvania Rhode Island South Carolina Tennessee Texas Utah Vermont Virginia Washington

Benefits/Perks

11 paid holidays Annual performance bonuses Dental Disability Insurance Employee benefits Life and Disability insurance Medical Medical, dental, and vision benefits Paid holidays Paid parental leave Paid sick time Paid wellness time Paid wellness time and reimbursements Performance bonuses Unlimited Vacation Unlimited vacation program Vision Vision Benefits

Tasks
  • Collaborate with teams
  • Compliance
  • Compliance with all applicable laws and regulations
  • Other duties as assigned
  • Process Improvement
  • Project management
  • Track deliverables
Skills

C Clinical Clinical operations Clinical Policy Compliance Consulting Cross-functional Collaboration Excel Health Insurance Operations Pharmacy Pipeline Management Policy Development PowerPoint Process Improvement Project Management Quality improvement Quality Standards Technology Technology Platform Utilization management

Experience

6 years

Education

Bachelor's Bachelor's degree BSN Certification MBA Pharm.D RN

Certifications

Process improvement Project Management Certification