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Senior Manager, Clinical & Disease Specific Insurance Solutions

1 hour, 28 minutes ago
United States
Full-time
Lead
Product Manager
Product Management
SQL
Apply Now
Oscar

Oscar

Oscar is a health insurance company that offers plans for individuals, families, and small businesses. With a focus on humanizing health care through technology, design, and data, Oscar provides easy-to-understand bills, 24/7 access to doctors, and a p...

Insurance
1K-5K
Founded 2012
View All Jobs 159

Description

  • Own the end-to-end lifecycle of clinical and disease-specific insurance products from strategy and benefit design through launch, performance management, and optimization.
  • Build and manage business cases for new and existing products, including financial modeling, membership projections, and performance tracking.
  • Analyze financial and membership performance to forecast results, identify risks and opportunities, and guide product decisions.
  • Lead benefit design for disease-specific plans, including improving existing offerings, remediating underperforming designs, and creating new benefit structures.
  • Design and manage product portfolios for defined clinical populations, including chronic condition, high-cost, high-utilization, and condition-specific care needs.
  • Contribute to annual planning, roadmap development, and prioritization for clinical and disease-specific products.
  • Identify risks, gaps, and opportunities across benefit design, performance, affordability, and access, and recommend corrective actions.
  • Execute clinical plan designs through internal approvals, filings, and supporting documentation.
  • Partner with regulatory and legal teams to incorporate federal and state guidance, clinical mandates, and medical policy changes into plan designs and pricing inputs.
  • Serve as the primary product DRI for clinical plans and coordinate across Clinical, Actuarial, Network, Medical Affairs, Finance, Legal, and Compliance.

Requirements

  • 6+ years of experience developing, managing, or supporting commercial insurance products, including clinical programs and disease-specific offerings.
  • 5+ years of experience with clinical policy, utilization management, quality programs, and regulatory requirements such as ACA, state mandates, and CMS guidance.
  • 3+ years of experience with ACA products, including the individual marketplace and small group products.
  • 3+ years of demonstrated ownership of end-to-end product lifecycle management.
  • 3+ years of experience leading cross-functionally in highly regulated, matrixed, and ambiguous environments.
  • 3+ years of experience making analytical, data-driven decisions and translating population-specific insights into product and benefit design decisions.
  • Ability to travel up to 25% of the time.
  • Bachelor’s degree in business, healthcare, public policy, analytics, or a related field (preferred).
  • Experience developing or managing clinically differentiated health plans (preferred).
  • Familiarity with medical policy development, clinical governance, provider models, regulatory filings and audits, SQL, Excel, or similar business intelligence tools, and population health or value-based care (preferred).

Benefits

  • Base salary of $149,040 - $195,615 per year in New Jersey, New York, and California, or $134,136 - $176,053 per year in other locations.
  • Eligible for annual performance bonuses.
  • Eligible for Oscar's unlimited vacation program.
  • Medical, dental, and vision benefits.
  • 11 paid holidays and paid sick time.
  • Paid parental leave.
  • 401(k) plan participation, life insurance, and disability insurance.
  • Paid wellness time and reimbursements.

Interested in this position?

Apply directly on the company website

Apply Now

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