Director, Medical Economics

Director, Medical Economics

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 Director, Medical Economics, plays an instrumental role in Oscar's medical economics operating model. You will be the lead architect and developer of our next generation of analytic tools. This role is for a hands-on technical expert who will personally develop a unified reporting suite to lead Oscar's Medical Economics program, providing transparent, relevant insights into medical cost and utilization drivers. You will be a project lead collaborating with leaders across the Medical Economics team to incorporate their analytic content into the unified reporting suite. You will lead the department's engagement with partners in the data science team to deliver the foundational datasets and infrastructure upon which the reporting suite will be built.

You will report to the Senior Director, Medical Cost Analytics.

Work Location : This is a remote position, open to candidates who reside in Hartford, CT. 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.

Pay Transparency : The base pay for this role is $192,000 - $252,000 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities :

• Perform hands-on development while providing direction, guidance, and requirements to supporting matrixed resources from other analytic and tech teams.
• Oversee decision-making responsibilities related to the technical design of a unified suite of medical economics reporting and analytic tooling that will be used to lead Oscar's Total Cost of Care (TCoC) efforts.
• Partner with Medical Economics leaders to create a multi-year roadmap for the tooling suite, including creation of a governance process for designing content and analytic methodologies.
• Develop automated dashboards and reports that decompose medical cost trends, highlighting important causes such as unit cost, utilization, mix of services, provider network changes.
• Be the subject matter expert on Oscar's medical claims data, and incorporate key healthcare methodologies (e.g., risk adjustment, episode groupers, case-mix adjustment) into the tooling suite.
• Ensure the tooling suite is designed to include generative AI for insight generation.
• Be the internal consultant, introducing and applying techniques (e.g., predictive modeling, statistical analysis, machine learning) to enhance the sophistication and predictive power of our tooling suite.
• Be the senior mentor and technical guide for analysts across the medical economics team, elevating the team's skills by promoting best practices in analytics and BI development.
• Develop relationships and lines of communication with main partners across the operational departments.
• Represent the medical economics function in cross-departmental forums, contributing to strategic planning.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Requirements :

Bonus points :