Manager, Medical Policy

Who you are

You have a strong background in clinical policy development and a passion for improving health outcomes. With experience in leading clinical research, you understand the importance of evidence-based medical necessity criteria and compliance with recognized standards. You excel in communication and collaboration, working effectively with cross-functional teams to ensure that medical policies are both compliant and beneficial for members. You are detail-oriented and possess the ability to analyze clinical literature critically, ensuring that policies are grounded in the latest evidence. You thrive in a hybrid work environment, balancing in-office collaboration with remote flexibility.

What you'll do

In this role, you will lead the clinical research and development of medical necessity criteria within the Office of Clinical Affairs. You will be responsible for overseeing the entire clinical lifecycle of medical policies, ensuring that coverage criteria for medical services, devices, and technologies are supported by current clinical literature. As the lead clinical subject matter expert, you will appraise medical evidence and ensure that our clinical policies are evidence-based and compliant. You will collaborate closely with the Associate Director of Clinical Policy to align on strategy and execution, contributing to the overall mission of Oscar to provide optimal health outcomes for our members. Your role will involve regular reviews of clinical literature and standards to keep our policies up-to-date and relevant. You will also participate in team meetings and events, fostering a collaborative environment that encourages innovation and continuous improvement.

What we offer

Oscar offers a competitive salary range of $131,200 - $172,200 per year, along with a comprehensive benefits package that includes participation in our unlimited vacation program and annual performance bonuses. You will have the opportunity to work in a supportive and innovative environment that values your contributions and encourages professional growth. We believe in the importance of work-life balance and provide a hybrid work schedule that allows for flexibility while maintaining team collaboration. Join us in our mission to transform health insurance and make a meaningful impact on the lives of our members.