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Manager, Utilization Management Design & Configuration

Oscar Health

Oscar Health

Posted on Wednesday, January 24, 2024

Hi, we're Oscar. We're hiring a Manager, Utilization Management Design & Configuration to join our Clinical Optimization team.

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

This role is responsible for designing, optimizing and implementing processes and improvements for configuring Oscar’s technology stack. This role leads a team to identify, scope, build, test and implement solutions, with a focus on creating efficiency and scale through technology and automation.

You will report to the Senior Manager of Design and Configuration.

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: $113,600 - $149,100 per year. The base pay for this role in all other locations is: $102,240 - $134,190 per year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program, and annual performance bonuses.


  • Lead, coach and develop a high-performing team
  • Support team and leadership by driving decisions, influencing team strategy, and ensuring accountability for deliverables on an ongoing basis
  • Works cross functionally to gather business requirements in order to implement and improve the efficacy and efficiency of existing operational processes or to unlock new platform capabilities
  • Utilizes data to independently drive business decisions, impact cross-functional strategy and develop KPIs to measure the effectiveness of your domain
  • Proactively identify risks; responds to and resolves issues/errors/escalations through data-driven investigation to produce insights for short, medium, and long-term technology-enabled solutions
  • Works with other team members to resolve issues, develop training, and create technical tooling to enable others
  • Compliance with all applicable laws and regulations
  • Other duties as assigned


  • A bachelor’s degree or commensurate 4 years of operating experience
  • 4+ years experience in operations, health insurance, data analysis, engineering and/or consulting
  • 4+ years of experience using data software such as Excel, SQL or Python
  • 4+ years experience developing project plans coordinating with internal and external stakeholders
  • 4+ years experience designing and improving workflows as well as standing up accompanying operating and technical procedures

Bonus Points

  • Process Improvement or Lean Six Sigma training
  • Experience with healthcare utilization management and referral management systems and processes

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.

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 ( to make the need for an accommodation known.