Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

In this role, you will join the Consumer Line Strategy team - In this role, you will have deep subject matter expertise around health insurance benefits, coverages, state and federal mandated coverage

You will report to the Associate Director, Insurance Product–Strategy.

This is a remote / work-from-home role. You must reside in one of the following states: Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $76,000- $99,750 per year. The base pay for this role in all other locations is: $68,400 - $89,775 per year. You are also eligible for employee benefits, and participation in Oscar’s unlimited vacation program.

Responsibilities

Analyze market-specific product portfolio and recommend enhancements and new capabilities to meet the needs of Individual health insurance consumers.
Analyze and synthesize external data (e.g., competitor, enrollment, and consumer trends) and internal metrics (e.g., financial targets, membership targets, customer pain points, etc.) by region.
Partner with Plan Design teams to manage coverage and exclusions language in Evidence of Coverage (EOCs).
Create and maintain benefit interpretation policies for OHI plans
Provide deep and ongoing research and analysis of industry best practices and emerging threats and trends with actionable industry knowledge
Delivery of accurate, timely insights on benefit strategy and policy as a subject matter expert (SME)
Resolve documentation and decision gaps escalated by downstream teams for all OHI plans and benefits
Decision Making: ability to manage ambiguity and use independent judgment in decision making

Qualifications

BS/BA degree in a related field or equivalent years of experience preferred.
3+ years prior experience in Health Insurance (Individual and/or Medicare Advantage) and/or Healthcare industry
Demonstrable knowledge and experience as a subject matter expert (SME) for benefit strategy and policy
Implement and support LOB Products. Developing functional knowledge of product configuration and filing tools internal tools, can include but not limited to: variations by state, state mandates, benefit nuances (e.g., virtual, Rx multiples, network, tiers, etc.)

Bonus Points

Previous experience of consultative engagement and collaboration with benefit configuration, plan design, clinical, legal, and compliance, technology, and other functional areas
Excellent financial and organizational systems acumen

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At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives..

Pay Transparency:

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.

Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

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