Senior Manager, Network Performance

Atlanta, GA - USA

Yearly Salary: $ 147549 - 193658

Posted on: Yesterday

Vacancies: 1 Vacancy

Job Summary

Hi were Oscar. Were hiring a Senior Manager Medical Economics to join our Medical Economics 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 ourselvesone that behaves like a doctor in the family.

About the role:

The Senior Manager Network Performance leads the analytical execution and operationalization of Oscars Value-Based Care (VBC) strategies. While supporting the broader network performance and analytics roadmap this role specifically focuses on designing modeling and monitoring alternative reimbursement modelsranging from shared savings to full capitation.

As a key partner to Network Actuarial and Finance stakeholders the Senior Manager brings technical rigor to economic modeling and contract valuation. This role is accountable for measuring the performance of VBC arrangements and driving actionable insights that support Oscars total cost of care (TCoC) and affordability goals.

You will report into the VP Medical Economics.

Work Location: This is a remote position open to candidates who reside in: Atlanta GA. You will be fully remote; however our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

Pay Transparency: The base pay for this role is: $147549 - $193658 per year. You are also eligible for employee benefits participation in Oscars unlimited vacation program and annual performance bonuses.

Primary Duties and Responsibilities

VBC Strategy Execution Execute against the Network Performance strategy by developing robust frameworks to evaluate and monitor Value-Based Care arrangements ensuring alignment with enterprise medical economics and TCoC goals.
Modeling & Deal Structuring Lead the design and maintenance of advanced models that forecast VBC deal performance calculate settlement outcomes (shared risk/savings) and assess the financial impact of capitated arrangements.
Cross-Functional Partnership Partner closely with Network Contracting Clinical and Actuarial teams to structure sustainable VBC contracts and inform negotiation strategies with data-driven risk assessments.
Methodology Development Develop and refine methodologies for benchmarking provider performance attributing populations and setting financial targets for risk-based arrangements ensuring transparency and analytical rigor.
Insight Generation Translate complex VBC performance data into clear strategic recommendations for leadership to optimize existing arrangements and identify new opportunities for payment innovation.
Team Leadership Manage and mentor a team of analysts; foster a culture of technical excellence accuracy and ownership over VBC analytical outputs.
Technical Bridge Serve as the technical lead ensuring that VBC analytical work connects directly to business outcomes and financial reporting.
Trend Monitoring Monitor VBC market trends regulatory changes in reimbursement and provider risk appetite to continuously improve Oscars modeling approaches.
Compliance with all applicable laws and regulations
Other duties as assigned

Required Experience and Education

Bachelors degree in a STEM field.
7 years of relevant quantitative analysis experience.
Proven experience in health insurance / payer analytics with an understanding of medical claims data (e.g. CPT/HCPCS ICD-10 DRGs) and standard healthcare industry data sources.

Preferred Experience and Education

Associate or Fellow of the Society of Actuaries (SOA) or on the track to become one.
Excellent communication collaboration and relationship-building skills.
Experience developing measurement of clinical intervention ROI.
Knowledge of prior authorization optimization and automation.
Familiarity with pharmacy economics.
Background in value-based care analytics.
Experience translating between clinical business and analytic vocabularies.

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. Were 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 applicants 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.

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 .

Required Experience:

Senior Manager

Hi were Oscar. Were hiring a Senior Manager Medical Economics to join our Medical Economics 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 co...