Manager • Mid-Level

Who you are

You have a strong background in clinical policy development and a deep understanding of medical necessity criteria — your experience allows you to lead the clinical research and development processes effectively. You are a clinical subject matter expert (SME) who ensures that medical policies are evidence-based and compliant with recognized standards. Your ability to analyze clinical literature and apply it to policy development is key to your success in this role.

You thrive in collaborative environments and enjoy working with cross-functional teams — your communication skills enable you to articulate complex clinical concepts to various stakeholders. You are detail-oriented and committed to ensuring that coverage criteria for medical services, devices, and technologies are supported by current clinical literature. You understand the importance of optimal health outcomes for plan members and are dedicated to achieving them.

You are adaptable and open to evolving work models — while this position is currently remote, you are prepared for potential hybrid work arrangements in the future. Your proactive approach to leadership and policy development makes you a valuable asset to the Medical Policy team at Oscar.

What you'll do

In this role, you will lead the end-to-end clinical lifecycle of medical policies, ensuring that they are developed based on the latest clinical evidence and standards. You will be responsible for reviewing and appraising medical evidence, making recommendations for policy changes, and ensuring compliance with regulatory requirements. Your expertise will guide the development of coverage criteria that support optimal health outcomes for Oscar's members.

You will collaborate closely with the Office of Clinical Affairs (OCA) and report to the Associate Director, Clinical Policy - Affordability. Your leadership will be crucial in driving the clinical research initiatives that inform policy development. You will also serve as a key resource for the team, providing insights and guidance on clinical matters.

Your role will involve engaging with various stakeholders, including clinical teams and external partners, to ensure that policies are aligned with best practices and member needs. You will monitor the implementation of policies and assess their impact on health outcomes, making adjustments as necessary to improve effectiveness.

What we offer

Oscar offers a competitive salary range of $131,200 - $172,200 per year, along with comprehensive employee benefits. You will have the opportunity to participate in Oscar's unlimited vacation program and be eligible for annual performance bonuses. The company fosters a culture of collaboration and innovation, encouraging you to contribute your ideas and expertise to improve health insurance services for members. You will be part of a mission-driven organization that prioritizes member care and strives to create a health insurance experience that feels personal and supportive.