Manager, Medical Economics Tooling

Job Description

Job Description

Hi, we're Oscar. We're hiring a Manager, Medical Economics Tooling to join our Actuarial 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, Medical Economics is a hands-on technical leader whose primary responsibility is to design dashboards, business-intelligence solutions, and other analytical products. The role turns Medical Economics and actuarial needs into trusted metric logic, curated datasets, visualizations, recurring analyses, and automation that make medical cost, utilization, membership, risk, and financial performance transparent and actionable.

The technology stack may evolve, but strong hands-on development capability is required. You will use the selected BI and data-development tools, with SQL, Python, or comparable code as appropriate; partners with stakeholders to define requirements; translates approved methodologies into reliable solutions; and owns complex products through launch, maintenance, and improvement. At the L5 level, the role also contributes technical standards, design and code review, documentation, and mentorship. You will remain hands-on and does not require direct people management.

You will report to a Senior Director in the Medical Economics department.

Work Location: This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $135,792 - $178,227 per year. The base pay for this role in all other locations is: $122,213 - $160,404 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

• Design and build dashboards, business-intelligence solutions, reusable metric logic, curated datasets, recurring analyses, and automation from the ground up. Use the selected BI and data-development tools, including SQL, Python, or comparable code, to build these solutions. The goal is to make medical cost, utilization, membership, risk, and financial performance transparent and actionable.
• Translate stakeholder requirements into clear technical designs. Also, translate approved actuarial and health-insurance methodologies into maintainable analytical solutions. In both cases, preserve approved definitions, denominators, completion approaches, risk-adjustment conventions, and financial tie-outs.
• We own complex solutions through the full development lifecycle, including requirements, prototyping, development, testing, user acceptance, deployment, monitoring, maintenance, and enhancement. We make technical decisions that balance speed, usability, reuse, reliability, and maintainability.
• Partner with Medical Economics, Actuarial, Finance, Data, BI, operational, and business stakeholders. This partnership helps to understand the decisions each solution must support, define its audience and success measures, prioritize requirements, manage dependencies, and resolve tradeoffs.
• Apply practical development and product standards. Strengthen these standards, including validation, code review, and documentation. Additionally, ensure data freshness, cross-product and financial tie-outs, and implement release controls and change management. Finally, develop plans to replace or retire legacy assets. Identify appropriate opportunities for reusable AI-enabled workflows so solutions remain reliable and supportable.
• Provide technical leadership by reviewing designs and code, guiding matrixed contributors, and mentoring colleagues in development, data analysis, visualization, testing, and governed delivery practices. Communicate completed solutions and resulting insights through recurring operational and executive readouts. Represent Medical Economics in cross-functional forums. Escalate material roadmap conflicts, dependencies, and decisions requiring leadership alignment.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Requirements:

• Bachelor's degree in a quantitative or technical field.
• 5+ years of quantitative analysis, business intelligence, actuarial, Medical Economics, healthcare data, or related experience; and/or significant experience in health insurance or another payer environment.
• Strong knowledge of medical claims and healthcare coding, including CPT/HCPCS, ICD-10, and DRGs, as well as pharmacy, authorization, membership, premium, risk adjustment, completion, or financial-performance data.
• Advanced hands-on proficiency with SQL and at least one general-purpose programming language, such as Python, for data transformation, automation, validation, analysis, and production tooling.

Bonus points:

• Demonstrated advanced experience with quantitative problem-solving, coding, technical design, and learning complex healthcare or financial concepts, evidenced through professional work, coursework, certifications, or comparable projects.
• Own and lead complex decision-support solutions from requirements through launch and maintenance, including coordinating work across technical, quantitative, and partners.
• Demonstrated experience designing, building from the ground up, deploying, and operating dashboards, recurring analyses, data products, or shared metric content used by business stakeholders.
• Experience applying software-development practices—including version control, modular and reusable code, code review, automated testing, release controls, and technical documentation—to production analytical products and recurring quantitative workflows.
• Experience translating ambiguous business needs and quantitative methodologies into technical designs, data models, component boundaries, priorities, and delivery plans.
• Experience leading work across multiple teams or matrixed contributors and communicating with technical, quantitative, and business audiences.
• Strong product judgment and process-management skills, with experience streamlining workflows and driving operational efficiency.
• Hands-on proficiency with a modern BI or visualization platform such as Looker, Tableau, Power BI, or a comparable tool.
• Experience with data-transformation frameworks, workflow orchestration, CI/CD or release automation, and performance or reliability optimization.
• Experience designing governed metric definitions, shared dimensions and measures, monitoring, or other shared quantitative infrastructure.
• Experience using AI-assisted or large-language-model tools for software development, data analysis, or insight generation, with appropriate validation, documentation, and governance.
• Associate or Fellow of the Society of Actuaries, or progress toward an SOA credential.

This is an authentic Oscar Health job opportunity.

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 (View email address on us.fitly.work) 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.