Manager, Medical Policy

Who you are

You have a strong background in clinical policy development and a passion for improving health outcomes. Your experience includes leading clinical research and ensuring compliance with medical necessity criteria. You are detail-oriented and possess excellent analytical skills, allowing you to appraise medical evidence effectively. You thrive in collaborative environments and are comfortable working with cross-functional teams to achieve common goals. You understand the importance of evidence-based practices and are committed to supporting optimal health outcomes for members. You are adaptable and can navigate the complexities of the healthcare landscape with ease.

What you'll do

In this role, you will lead the clinical research and development of evidence-based medical necessity criteria within the Office of Clinical Affairs. You will be responsible for the end-to-end clinical lifecycle of medical policies, ensuring that coverage criteria for medical services, devices, and technologies are supported by current clinical literature and nationally recognized standards. As the lead clinical subject matter expert, you will ensure our clinical policies are evidence-based, compliant, and supportive of optimal health outcomes for Plan members. You will collaborate closely with the Associate Director of Clinical Policy to align on strategic initiatives and contribute to the overall mission of Oscar. Your role will involve regular communication with stakeholders to ensure clarity and alignment on clinical policies and practices.

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 hybrid environment, with three days in the office and flexibility for remote work. Our culture emphasizes collaboration, innovation, and a commitment to serving our members effectively. We encourage you to apply even if your experience doesn't match every requirement, as we value diverse perspectives and backgrounds.