Manager, Medical Economics Tooling

🔥 13 hours ago

🇺🇸 United States – Remote

💵 $122.2k - $160.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Oscar Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2012

⚕️ Healthcare Insurance

🏥 Healthcare

💰 $355M Post-IPO Debt - Oscar Health on 2025-09

Healthcare Insurance • Healthcare

Oscar Health is a technology-driven health insurance company that provides individual, family, and small-group health plans in multiple U. S. states. Oscar combines traditional insurance underwriting with digital-first services — a consumer-facing app, 24/7 virtual urgent care, prescription delivery (including $3 meds in many plans), and dedicated Care Teams — and also operates Oscar Primary Care in some markets. The company emphasizes accessible, affordable, high-quality care and uses AI to improve member experience and care delivery. Insurance policies are underwritten by Oscar's state insurance subsidiaries and the company offers both HMO and other plan types across its markets.

📋 Description

• Design and build dashboards, business-intelligence solutions, reusable metric logic, curated datasets, recurring analyses, and automation • Use BI and data-development tools, including SQL, Python, or comparable code, to make medical cost, utilization, membership, risk, and financial performance transparent and actionable • Translate stakeholder requirements into clear technical designs • Translate approved actuarial and health-insurance methodologies into maintainable analytical solutions • Preserve approved definitions, denominators, completion approaches, risk-adjustment conventions, and financial tie-outs • Own complex solutions through requirements, prototyping, development, testing, user acceptance, deployment, monitoring, maintenance, and enhancement • Make technical decisions balancing speed, usability, reuse, reliability, and maintainability • Partner with Medical Economics, Actuarial, Finance, Data, BI, operational, and business stakeholders • Define audiences and success measures, prioritize requirements, manage dependencies, and resolve tradeoffs • Strengthen validation, code review, and documentation standards • Ensure data freshness, cross-product and financial tie-outs; implement release controls and change management • Develop plans to replace or retire legacy assets • Identify appropriate opportunities for reusable AI-enabled workflows • Review designs and code, guide matrixed contributors, and mentor colleagues • Communicate completed solutions and insights through recurring operational and executive readouts • Represent Medical Economics in cross-functional forums • Escalate material roadmap conflicts, dependencies, and decisions requiring leadership alignment • Report to a Senior Director in the Medical Economics department • Perform other duties as assigned

🎯 Requirements

• Bachelor's degree in a quantitative or technical field • 5+ years of quantitative analysis, business intelligence, actuarial, Medical Economics, healthcare data, or related experience; and/or significant experience in health insurance or another payer environment • Strong knowledge of medical claims and healthcare coding, including CPT/HCPCS, ICD-10, and DRGs • Knowledge of pharmacy, authorization, membership, premium, risk adjustment, completion, or financial-performance data • Advanced hands-on proficiency with SQL • Proficiency with at least one general-purpose programming language, such as Python • Compliance with all applicable laws and regulations • Candidates must reside in the U.S., excluding Alaska, Delaware, Hawaii, Louisiana, Montana, North Dakota, Oklahoma, West Virginia, Wyoming, and U.S. Territories • Bonus: advanced experience with quantitative problem-solving, coding, technical design, and complex healthcare or financial concepts • Bonus: experience owning complex decision-support solutions from requirements through launch and maintenance • Bonus: experience designing, building, deploying, and operating dashboards, recurring analyses, data products, or shared metric content • Bonus: software-development practices including version control, modular and reusable code, code review, automated testing, release controls, and technical documentation • Bonus: translating ambiguous business needs and quantitative methodologies into technical designs, data models, component boundaries, priorities, and delivery plans • Bonus: leading work across multiple teams or matrixed contributors • Bonus: modern BI or visualization platform experience such as Looker, Tableau, or Power BI • Bonus: data-transformation frameworks, workflow orchestration, CI/CD or release automation, and performance or reliability optimization • Bonus: governed metric definitions, shared dimensions and measures, monitoring, or shared quantitative infrastructure • Bonus: AI-assisted or large-language-model tools for software development, data analysis, or insight generation • Bonus: Associate or Fellow of the Society of Actuaries, or progress toward an SOA credential

🏖️ Benefits

• Employee benefits • Oscar's unlimited vacation program • Annual performance bonuses • Medical benefits • Dental benefits • Vision benefits • 11 paid holidays • Paid sick time • Paid parental leave • 401(k) plan participation • Life insurance • Disability insurance • Paid wellness time • Wellness reimbursements • Occasional travel for team meetings and company events