Senior Manager, UM Authorization Strategy

Summary

Join Oscar, a health insurance company built on a technology platform, as a Sr. Manager, UM Authorization Strategy. You will collaborate with clinical and non-clinical teams to enhance Oscar's UM Operations, defining and implementing a prior authorization strategy to improve program ROI. Responsibilities include managing performance, partnering with data science and clinical teams, and ensuring alignment with clinical policy. This role requires significant experience in strategy and operations, project management, and data analysis. The position offers a blended work culture with remote options and a competitive salary and benefits package, including health insurance, paid time off, and performance bonuses. Location flexibility is available, but you must reside in one of the specified states.

Requirements

• 6+ years experience in strategy and operations
• 4+ years project planning and program management experience
• Expertise in working with data and making data backed decisions

Responsibilities

• Improve the UM program's ROI by defining the prior authorization strategy
• Identify success criteria, and implement operating metrics to measure success; analyze data to own root cause analysis and implement mitigation strategies
• Evaluate data to drive performance improvement and create dashboards for Senior Leadership report outs
• Partner with Data Science and clinical teams to understand current utilization trends and identify opportunities to bend the cost curve
• Work with the clinical policy team to make sure there is alignment between clinical policy and prior authorization strategy
• Program management of key department and cross functional strategy initiatives
• Build operating playbooks and workflows to get the most value out of department initiatives
• Compliance with all applicable laws and regulations
• Other duties as assigned

Preferred Qualifications

• Master's degree
• 6+ years experience working in healthcare or insurance industries in a strategy, business development, or project management role
• Experience in prior authorization strategy vertical with a payer
• Clinical experience

Benefits

• Medical, dental, and vision benefits
• 11 paid holidays
• Paid sick time
• Paid parental leave
• 401(k) plan participation
• Life and disability insurance
• Paid wellness time and reimbursements
• Annual performance bonuses
• Oscar's unlimited vacation program