Remote Senior Manager

Summary

Join Oscar's Clinical Policy team as a Senior Manager, responsible for driving affordability goals through policy development and ensuring clinical quality standards. You will work with cross-functional leaders to develop new policies, oversee a team, and report to the VP, Clinical Policy.

Requirements

• Bachelor's degree in relevant field of study or 4+ years of commensurate experience - PharmD, BSN, or RN required
• 6+ years of direct work with clinical policy, with particular emphasis on health insurance policy experience
• 5+ years of work experience in utilization management and/or clinical operations
• 5+ years of experience in designing, implementing and continuously improving programs and processes
• 5+ years of experience communicating and presenting to stakeholders of all levels
• 5+ years of experience using Excel and powerpoint
• 5+ years of experience managing and building a team

Responsibilities

• Interacts regularly with all levels of management on matters concerning several functional areas, department, and/or customers
• 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 of medical and pharmacy policy research and recommendation as well as accurate incorporation into partner claims organizations (Oscar and external)
• Bring industry best practice to policy development process to develop organizational frameworks, templates, process organization, evidentiary source of truth internal references, to create consistency, repeatability, and clear points of interconnectivity between policy organization and other teams. Monitor quality trends and identify gaps to drive quality improvement activities
• Track all deliverables to ensure the organization is meeting SLAs and TAT. Develop SLAs and TAT where needed. Identify and lead process improvement where needed
• Compliance with all applicable laws and regulations

Preferred Qualifications

• MBA or advanced management degree
• Experience working in a fast-paced, collaborative environment
• Project management certification
• Consulting experience

Benefits

• Medical benefits
• Dental benefits
• Vision benefits
• 11 paid holidays
• Paid sick time
• Paid parental leave
• 401(k) plan participation
• Life and disability insurance
• Paid wellness time and reimbursements