Associate, Medical Economics

Job Description

Job Description

Hi, we're Oscar. We're hiring an Associate, 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 ourselves—one that behaves like a doctor in the family.

About the role :

The Associate, Medical Economics, is part of our Medical Cost Analytics team within the Medical Economics department. The Associate reports to the Senior Director, Medical Economics, and is part of a team that analyzes medical costs to understand trend drivers, project financial outcomes, monitor programs, and identify cost savings opportunities. You will partner with Medical Economics leadership, Data Science, Finance, Payment Integrity, and other analytic support responsibilities to ensure accurate projections are reflected in management reporting.

You will report into the Senior Director, Medical Economics.

Work Location : This position is based in our Tempe, AZ office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid

Pay Transparency : The base pay for this role is : $118,080 - $154,980 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities :

• Work under the guidance of the Senior Director, Medical Economics.
• Maintain sophisticated models to forecast the financial impact of proposed changes to clinical and payment policies. Conduct sensitivity analyses and stress testing on models to understand the range of potential outcomes under multiple utilization and cost scenarios.
• Develop knowledge of industry best practices and work to drive innovation.
• Perform in-depth analysis of integrated claims and operational data (medical, pharmacy, lab, auths) to identify cost and trend drivers.
• Provide proactive financial guidance on latest clinical trends and their potential impact on our financial performance.
• Accomplish retrospective studies to measure the actual financial and clinical outcomes of implemented policies, comparing results against initial projections.
• Build repeatable analytic processes that scale across programs.
• Create executive-ready visualizations tailored to different stakeholder audiences (clinical vs. financial).
• Promote and shape Oscar best practices concerning automation and documentation. Contribute to department initiatives around automation, AI use, and tooling improvements.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements :

Bonus points :

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.

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 applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

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