Oscar Insurance is hiring a

Senior Director, Medical Cost Management

New York, United States

Hi, we're Oscar. We’re hiring a Senior Director of Medical Cost Management to identify, design and lead initiatives that maximize the healthcare value that we get from every dollar that we spend on medical costs.  

Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, transparent, and human. We need your help to do so.

About the role:

Healthcare is expensive, and as an insurer our primary goal is to make sure that we get the best value for our members. But there is no silver bullet to controlling medical costs; an effective cost-management strategy takes a deep and broad portfolio approach that tailors the plan to local market dynamics and pulls all of the levers we have available, including network and plan design, utilization management, member engagement. 

You will be the founding leader with a small team of industry experts to drive actionable insights and analysis to find the largest opportunities and come up with tangible actions we can take that will maximize our risk-adjusted profitability. You will have the opportunity to formulate the strategy, outline a cross-functional operating model, develop the tools, and recruit a team of world-class analysts. The actionable insights derived and implemented by your team will have executive-level visibility; guiding program, region, market and provider-level strategies to identify and eliminate inefficient and ineffective healthcare.  This role requires an analytical mind, executive-level communication, contemporary data visualization/presentation, and direct/indirect leadership skills. 

Responsibilities:

  • Develop a firm-wide Medical Cost Management plan for the business and represent it to leadership and key stakeholders to secure internal buy-in while integrating into regional leadership team’s quarterly, annual and multi-year business plans
  • Lead organizational efforts to synthesize medical cost trends, and identify actions to achieve medical and pharmacy cost improvements spanning network and clinical 
  • Develop action plans to address identified opportunities, including researching industry standards, vendor solutions and the build requirements for internal solutions
  • Partner with Data Science, Finance, Actuarial, and Clinical teams to implement best-in-class methods to systematically identify and manage medical cost drivers
  • Utilize historical, predicted, and competitive market data to recommend benchmarks for setting expectations for, and measuring, financial and operating performance (KPIs) for Oscar’s primary books of business
  • Develop metrics, reports and models to enable effective monitoring and analysis of network, condition management, site of care, and unit cost improvement programs 
  • Collaborate with enterprise data and technology partners to ensure the company’s data strategy supports program performance monitoring and stakeholder reporting needs
  • Build strong relationships within the organization including Regional VP’s, Regional Medical Directors / Clinical Operations, Finance, Actuary, and Data
  • Recruit and develop an industry-leading team
  • Establish and maintain a cross-functional organizational and operating model to effectively set and accomplish Oscar’s shared goals and objectives

Requirements:

  • Bachelor’s degree in finance, statistics, mathematics, analytics or related field
  • 10+ years of relevant work experience in healthcare finance, healthcare consulting, network analytics or analysis on health care data
  • Experience building, leading and growing teams
  • Experience presenting to senior leadership, including C-level executives both internally and externally 
  • Proficiency working with query, business intelligence and statistical tools
  • Proficiency in financial modeling and financial analysis needed to determine ROI in decision-making processes

Bonus points:

  • MBA or MS or equivalent advanced healthcare experience 
  • Experience with growth-stage enterprises
  • Managed care experience

Life at Oscar: 

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.

We encourage our members to care for their whole selves, and we encourage our employees to do the same with comprehensive medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, and volunteer opportunities.

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 ([email protected]) to make the need for an accommodation known.

Pay Transparency Policy:

Oscar ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.