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Senior Manager, Clinical & Disease Specific Insurance Solutions

16 hours, 25 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 70

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 product performance using financial and membership metrics to forecast results, identify risks and opportunities, and support decision-making.
  • Lead benefit design for disease-specific plans and adjust existing offerings based on clinical insight, utilization patterns, and product performance.
  • Design and manage product portfolios for defined clinical populations, including chronic conditions, high-cost, high-utilization, or 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, affordability, access, and performance, and recommend corrective actions.
  • Drive execution of 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 DRI for clinical plans and coordinate across Clinical, Actuarial, Network, Medical Affairs, Finance, Legal, and Compliance.
  • Develop and maintain performance reporting and product look-backs across financial, clinical, operational, and outcomes measures.
  • Lead cross-functional execution for product enhancements, pilots, and issue resolution.

Requirements

  • 6+ years of experience developing, managing, or supporting commercial insurance products, including clinical programs and disease-specific product 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 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.
  • 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, and provider models (preferred).
  • Experience supporting regulatory filings and audits (preferred).
  • Experience managing products for chronic conditions, high-utilizer populations, or disease-specific cohorts (preferred).
  • Experience with business intelligence tools, SQL, Excel, or similar tools (preferred).
  • Experience incorporating clinical outcomes, quality measures, and care management programs into product design (preferred).
  • Background in population health, value-based care, or care delivery innovation (preferred).

Benefits

  • Remote / work-from-home role.
  • Eligible for Oscar employee benefits.
  • Base salary of $149,040 - $195,615 per year in New Jersey, New York, and California.
  • Base salary of $134,136 - $176,053 per year in all other locations.
  • Unlimited vacation program.
  • Annual performance bonuses.
  • Medical, dental, and vision benefits.
  • 11 paid holidays, paid sick time, and paid parental leave.
  • 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Interested in this position?

Apply directly on the company website

Apply Now

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