UM Affordability & Value Analytics Manager

Oscar Health

🔍 Observed

$106K - $139K USD

Atlanta, Georgia, United States First seen 3 weeks ago Last seen 3 hours, 43 minutes ago Greenhouse

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Job Description

AI Summary

• Leads financial analysis and ROI tracking for utilization management (UM) initiatives, building actuarially sound models to quantify the impact of strategic investments on affordability outcomes • Serves as liaison between UM business unit and Medical Economics/Actuarial teams, maintaining accurate sizing and tracking of all UM investments while reporting monthly performance metrics • Requires 4+ years program management experience, 3+ years project delivery experience, and 3+ years financial modeling; bonus experience in Medical Economics or Actuarial Science • Remote position based in Atlanta, Georgia with salary range of $105,808-$138,886 annually, plus benefits, unlimited vacation, and performance bonuses • May include direct team oversight and mentoring responsibilities, with potential for hybrid work arrangements in the future

Hi, we're Oscar. We're hiring a UM Affordability & Value Analytics Manager to join our UM Strategy team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless 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:

The Manager of Affordability & Value Analytics is heavily embedded in the financial oversight of the UM Strategy team. In this role, you are responsible for quantifying and communicating the financial impact of all UM initiatives. Your core goal is to ensure that strategic investments translate into measurable, defensible affordability outcomes. You will serve as the primary liaison between the UM business unit and the Medical Economics/Actuarial departments to ensure all investments are accurately sized and tracked.

You will report into the Director, UM Authorization Strategy.

Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

Pay Transparency: The base pay for this role is: $105,808 - $138,886 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

Responsibilities:

Build complex financial modeling, actuarially sound models to size the impact of UM strategies
Represent the UM department within the broader organization's financial workstreams, ensuring UM initiatives are prioritized and recognized in the corporate savings pipeline.
Establish and maintain strong relationships with the Medical Economics and Data Science teams to develop vetted methodologies for tracking ROI.
Own the "Source of Truth" for the department's value tracking. You will monitor the performance of active initiatives and provide monthly "True-Up" reports comparing projected savings to actualized results.
Create data-driven frameworks to help leadership make "Go/No-Go" decisions on new strategic investments based on projected ROI and speed to value.
Collaboratively works with all relevant internal and external stakeholder groups to formulate proactive implementation, communications, and program strategies for successful change management and risk mitigation initiatives
May oversee team members directly as well as mentors team members and promotes colleagues' growth and professional development
Compliance with all applicable laws and regulations
Other duties as assigned

Requirements:

4+ years of experience in program management
3+ years of experience in delivering projects / programs
3+ years of financial modeling

Bonus points:

Experience with Medical Economics or Actuarial Science
Strong understanding of ACA market and UM impact on Risk Adjustment / Medical Loss Ratio
Experience using data and metrics to drive improvements in programs
Experience / background in a fast-paced operations environment
Successfully executed enterprise-wide initiatives: defined project plans, coordinated resources, managed implementation activities, and developed all processes associated with program rollout and ongoing support
Master's Degree
PMP Certifications or Program Management Certifications
Lean/Six Sigma Certifications
Healthcare experience (Health Insurance, Health Systems, or Healthcare Consulting)

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

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.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

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.

California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy.

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Job Information

Company:
Oscar Health
Location:
Atlanta, Georgia, United States
Experience Level:
Senior
Source:
Greenhouse
Status:
Active

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65 /100

Likely Active (65)

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