Manager, Policy Optimization - Remote

Overview

As a Manager, Policy Optimization, you will be a key member of our Clinical Policy team, focusing on driving affordability goals through policy analysis and optimization.

In Short

• Track policy performance and identify areas for process changes.
• Develop tracking systems for policy opportunities.
• Assess and streamline policy structures.
• Create evidence-based recommendations for policy modifications.
• Incorporate data for continuous improvement.
• Implement industry best practices in policy optimization.
• Analyze integrated claims and operational data.
• Create executive-ready visualizations for stakeholders.
• Maintain strong stakeholder relationships.
• Ensure compliance with laws and regulations.

Requirements

• Bachelor's degree in a relevant field (e.g., B.S.Pharm, PharmD).
• Active, unrestricted clinical license.
• 4+ years of experience in clinical policy, particularly in health insurance.
• 4+ years in utilization management or clinical operations.
• Experience in designing and improving programs and processes.
• Strong communication skills with stakeholders.
• Experience with Excel/Google Sheets and PowerPoint/Google Slides.
• Knowledge of medical and pharmacy coding.

Benefits

• Participation in Oscar's unlimited vacation program.
• Annual performance bonuses.
• Medical, dental, and vision benefits.
• 401(k) plan participation.
• Paid sick time and parental leave.
• Life and disability insurance.
• Paid wellness time and reimbursements.
• Continuous learning and development opportunities.
• Supportive work environment promoting authenticity.
• Opportunity to impact health care positively.