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Hi, we're Oscar. We're hiring an Associate, Risk / Compliance to join our Corporate Compliance 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, Risk / Compliance ensures that Oscar complies with industry specifications, standards, regulations, and laws. They review operational practices, create and enforce policies & procedures, and perform regulatory reviews. You will ensure and enforce compliance where required throughout the facility to ensure complete compliance in all areas of the business. You will report into the Senior Manager, Corporate Compliance. 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: $88,560 - $116,235 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Communicate with all relevant departments to make sure current compliance levels. Provide training to team members regarding regulatory compliance. Ensure that all team members are aware of the procedures to be followed to follow compliance requirements. Develop and implement compliance improvement plans where required. Delegate tasks to other departments to bring compliance levels up. Develop reports to the governing body. Assist Regulatory Authorities with completing site visits and external audits. Prepare for, and conduct audits alongside external authorities. Conduct regular audits in all required areas to make sure compliance levels. Compliance with all applicable laws and regulations Other duties as assigned Requirements: Bachelor's Degree or equivalent work experience 1+ year experience in health plan compliance 2+ years experience with State DOI health insurance rules and regulations, CMS ACA rules and requirements, CMS requirements 2+ years experience managing high-volume and complicated projects, keeping track of details, and staging work to complete projects on time Bonus points: CHC, CCEC, or similar Fluency with State DOI audit and/or reporting obligations State DOI audit management experience Experience in a start-up and/or health tech environment Experience in a TPA setting 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. 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 Privacy Policy.

Hi, we're Oscar. We're hiring a Manager, Formulary & Medical Pharmacy Operations to join our Pharmacy 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: You will oversee and manage clinical pharmacy initiatives driving affordability savings including core formulary management operations. You will partner across Pharmacy, Medical Economics, and the Office of Clinical Affairs to operationalize pharmacy related workflows and monitor existing savings initiatives for drugs on both the pharmacy and medical benefits. You will report to the Senior Manager, Formulary Operations and Pharmacy Utilization Management. Work Location: This is a remote position, open to candidates who reside in: Pittsburgh, PA area. 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: $144,000 - $189,000 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: * Provide insights and recommendations for trend management and clinical effectiveness, including serving as a key contributor in the enterprise affordability process for pharmacy * Manage the pipeline of enterprise affordability projects across the pharmacy department (program operations and clinical) and oversee the performance of active initiatives * Partner with leads across the organization as necessary in order to communicate, understand and identify upstream and downstream impacts to the business * Contribute to the design and implementation of clinical programs focused on improving patient outcomes and reducing costs. * These programs may include medication adherence initiatives, chronic disease management programs, and patient education efforts * Operationalize, develop and maintain a clinically appropriate and cost-effective formulary by operating and managing Oscar's P&T committee, which includes evaluating new developments in the drug treatment landscape and providing recommendations on how to manage new to market drugs and new drug indications. * Oversee and optimize medical pharmacy preferred drug lists and strategies to supports utilization of lowest unit cost infusion products * Provide written recommendations with responses and corresponding documentation for regulatory inquiries, feedback on future legislation, and other business questions that probe at formulary operations. * Accountable and responsible for maintaining mental health parity NQTL responses and working cross-functionally for future filings and responding to ongoing objections during the audit process. * Compliance with all applicable laws and regulations * Other duties as assigned Requirements: * Doctor of Pharmacy degree (PharmD) * 4+ years working for PBM or Payer in clinical pharmacy operations * 4+ years leading cross-functional teams/projects and change management * 3+ years supporting formulary management (P&T Committee, clinical policy development, formulary run operations) Bonus points: * Residency Training * Experience with Marketplace Exchange 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. 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 Privacy Policy.

Job Description Hi, we're Oscar. We're hiring a Internal Audit Lead to join our Internal Audit 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 Internal Audit lead meaningfully contributes in our dynamic Internal Audit (IA) function. You will flex between IT and operational/business internal audits, providing assurance and insights that strengthen risk management and internal controls across the organization. The Internal Audit lead leads and executes multiple internal audit engagements, working with IA leadership. You will report into the IT Internal Audit Associate Director. 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. #LI-Remote Pay Transparency: The base pay for this role is: $103,200 - $134,450 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Lead internal audits covering IT systems, cybersecurity, and operational processes Evaluate risks, control design and operating effectiveness, and process improvement opportunities Write clear, relevant internal audit reports and track finding remediation efforts Present findings and articulate risks and possible effects to management Help with risk assessment and development of annual audit plan Partner with IT, Operations, Compliance, Security and Finance teams on key initiatives Contribute to the continuous improvement of the Internal Audit function by developing and enhancing audit methodologies, tools, and best practices Develop relationships with partners to understand functions, processes, potential risks and influence the risk mitigation efforts Compliance with all applicable laws and regulations. Other duties as assigned. Requirements: Bachelor's Degree in Accounting, Finance, Business, Data Science, Information Systems, or other related fields, or 4 years of commensurate experience. 3+ years experience in internal audit or a similar role, in Big4 or public companies 2+ years of relevant industry experience (healthcare, insurance, and / or technology) Knowledge of ITGCs, cybersecurity, and business process controls Familiarity with COSO, COBIT, NIST, HIPAA, SOX, or HITRUST Strong communication, analytical, and project management skills Bonus points: CPA, CIA, CISA, or other audit-related certifications preferred Insurance and healthcare Familiarity with data & analytics and willingness to enhance skillset 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. 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 Privacy Policy.

Hi, we're Oscar. We're hiring an Associate, Actuary to join our Actuarial 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, Actuarial supports pricing for several ACA markets and leads efforts to maintain pricing and plan design modeling. The Associate is a critical partner to Market P&L, Insurance Product and other Analytic support functions for consultation of regional specific pricing, network and product strategy. They also support the regulatory submission process, support plan design compliance, and will ensure pricing is actuarially sound. You will report into the Associate Director, Actuarial. 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. #LI-Remote Pay Transparency: The base pay for this role is: $113,600 - $149,100 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Maintain core pricing and plan design models. Ensure consistency and standardization across team users. Important contributor in developing and submitting regulatory filings, and developing a viewpoint and recommendation for strategic pricing decisions. Provide an actuarial viewpoint across cross-functional teams for Oscar's ACA-compliant Individual and Small Group markets as we grow in our markets. Promote and shape Oscar actuarial best practices concerning automation and documentation. Maintain relationships, partnership, and lines of communication with both internal and external stakeholders. Aid in the onboarding of analysts by collaborating and integrating them into existing processes. Compliance with all applicable laws and regulations Other duties as assigned Requirements: College degree in a STEM field. Associate or Fellow of the Society of Actuaries (SOA), or on the track to become one. 4+ years of quantitative analysis experience. Bonus points: Excellent communication, collaboration, and relationship-building skills. Strong understanding of health insurance concepts and nuances. 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. 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 Privacy Policy.

Hi, we're Oscar. We're hiring a Payment Policy Associate to join our Payment Integrity 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 Payment Policy Associate manages and executes all payment policy activities, including organizing, scoping, investigating, and resolving payment policy issues. Responsibilities also involve delegating and prioritizing project tasks effectively. This work relies on internal team research and a thorough understanding of Oscar's claim infrastructure to draft and update payment policies accurately. You will report into the Manager, Payment Policy. Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah.. 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: $79,920 - $104,895 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Provide subject matter expertise and in-depth understanding of Payment Integrity internal claims processing edits, external vendor edits and Oscar reimbursement policies. Analyze data mining and process monitoring to pinpoint claims payment issues, then define the scope and steps for policy remediation. Examine industry standards to confirm claim payments align with industry best practices, internal policies, and regulations-both industry-wide and Oscar-specific. Respond to internal and external inquiries and disputes regarding policies and edits. Document industry standard coding rules and draft recommendations on reimbursement policy language and scope. Ideate payment integrity opportunities based on a deep knowledge of industry standard coding rules. Translate into business requirements; submit to and collaborate with internal partners to effectuate change. Attend regulation update meetings and relay information to team members, providing training and education as needed. Perpetuate a culture of transparency and collaboration by keeping stakeholders well informed of progress, status changes, blockers, completion, etc.; field questions as appropriate. Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc. whenever issues are escalated and assigned by leadership. Compliance with all applicable laws and regulations Other duties as assigned Requirements: A bachelor's degree or 4+ years of commensurate experience 4+ years of experience in claims processing, coding, auditing or health care operations 4+ years experience in medical coding Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA) Experience with reimbursement methodologies, provider contract concepts and common claims processing/resolution practices. 3+ year(s) ability to work independently to drive projects to completion Bonus points: 3+ years of experience working with large data sets using excel or a database language Knowledge management, training, or content development in operational settings Process Improvement or Lean Six Sigma training Experience using SQL 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. 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 .

Hi, we're Oscar. We're hiring a Case Management Nurse to join our Case Mangement 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: You will educate members on improving health outcomes, assist with transitions from care settings, participate in process improvement and other pilot programs as they arise, and work with support teams to ensure exceptional care for our members. You will report into the Associate Director, Clinical. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $39.28 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year. Responsibilities: Assist in the coordination of care across a variety of settings (inpatient, outpatient, post acute, ER, home care) Actively reach out to members undergoing difficult health challenges and develop care plans Proactively reach out to hospital case managers to assist with discharge planning Communicate with members via phone or secure messaging to provide education on health conditions, new medications, and procedures. Compliance with all applicable laws and regulations Other duties as assigned Requirements: Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license Ability to obtain additional state licenses to meet business needs 2+ years of clinical experience to include payer, hospital, outpatient or community based care management 1+ years of experience in Care Coordination and Navigation Bonus points: CCM Certification Bilingual in Spanish and/or creole reading, writing, speaking BSN Working knowledge of Milliman Guidelines 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. 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 Privacy Policy.

Hi, we're Oscar. We're hiring an Associate, Itemized Bill Review to join our Payment Integrity 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, Payment Integrity, Itemized Bill Review (IBR) will be responsible for executing internal payment integrity solutions requiring billing and coding expertise with and continual improvement and development of the solutions. You will ensure claims are paid accurately and timely with the highest quality. This is accomplished by leveraging a deep understanding of Oscar's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement. You will report into the Manager, Payment Integrity (Pre-Pay). Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah. 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: $79,920 - $104,895 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities: Perform line-by-line review of high-dollar facility itemized bills and corresponding claim forms (e.g., UB-04s) Proactively identify and document potential billing errors, including duplicate billing of items, services, or procedures as improper unbundling of services (e.g., separating components that should be billed together) and charges for non-covered or non-rendered services Compare billed charges against both payor-specific contracts and industry guidelines to confirm appropriate billing practices. Apply working knowledge of national coding systems (e.g., CPT, HCPCS, ICD-10, MS-DRGs) to validate the accuracy of codes used for services billed. Review claims eligible under specific reimbursement scenarios: a percentage of charges or those exceeding stop-loss levels, ensuring the claim exceeds the minimum dollar threshold set by the payor Prepare clear, concise, and professional documentation of all findings, including savings identified, policy violations, and recommended claim adjustments Contribute to the refinement of internal audit processes and tools to enhance efficiency and accuracy in identifying claim inaccuracies Serve as a subject matter expert for internal and external stakeholders regarding complex billing issues, coding guidelines, and payor policies Provide subject matter expertise and in-depth understanding of Payment Integrity internal claims processing edits, external vendor edits and Oscar reimbursement policies Identify claims payment issues from data mining, process monitoring, etc., provide scoping and action steps needed to remediate the issue Respond to internal and external inquiries and disputes regarding policies and edits. Document industry standard coding rules and provide recommendations on reimbursement policy language and scope Ideate payment integrity opportunities based on a deep knowledge of industry standard coding rules. Translate into business requirements; submit to and collaborate with internal partners to effectuate change Provide training and education to team members when necessary Perpetuate a culture of transparency and collaboration by keeping stakeholders well informed of progress, status changes, blockers, completion, etc.; field questions as appropriate Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc. whenever issues are escalated and assigned by leadership Compliance with all applicable laws and regulations Other duties as assigned Requirements: A bachelor's degree or 4+ years of commensurate experience 2+ years of bill / coding audit experience with a focus on hospital or facility billing (UB-04) 4+ years experience in medical coding Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA) Experience with reimbursement methodologies, provider contract concepts and common claims processing/resolution practices Bonus points: 3+ years of experience working with large data sets using excel or a database language Knowledge management, training, or content development in operational settings Process Improvement or Lean Six Sigma training Experience using SQL 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. 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 .

Hi, we're Oscar. We're hiring a Treasury Manager to join our Strategic Finance. 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 Treasury Manager is an individual contributor responsible for managing Oscar Health's important treasury operations and daily liquidity. You will provide critical daily execution of cash management activities, optimizes cash usage across subsidiaries, and guides operational efficiencies in banking and treasury systems. The Manager will be a critical partner to the Treasury organization, driving the execution of cash management strategies in a capital-intensive insurance environment. You have a deep, operational understanding of Treasury practices. You will report into the Senior Director, Assistant Treasurer. 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. #LI-Remote Pay Transparency: The base pay for this role is: $108,000 - $141,750 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Liquidity Management & Optimization: Recommend and monitor minimum cash balances required at subsidiaries, based on forecasts from the Capital Planning team, to ensure safety and liquidity while optimizing excess cash for investment. Guide the efficient use of cash across the Parent and Subsidiaries. Cash Flow Reporting & Forecasting: Responsible for updating actual cash flows for each subsidiary and synchronizing with the Capital Planning team to ensure forecasted outflows are current. Updated cash forecasts and variances to the broader finance team. Reconciliation and Performance Analysis: Reconcile actual cash balances reported from Accounting with Treasury forecasts to true-up balances. Describe actual versus forecast variances, and update Net Investment Income (NII) actuals related to cash and short-term holdings. Operational Oversight & Execution: Build all critical treasury operations and daily banking activities. This includes ensuring accurate daily funds settlement, bank account maintenance, processing signatory updates, and the administration of bank portal systems (e.g., CashPro, JPM Access, WF Vantage). Risk & Fee Analysis: Measure banking service fees paid to financial institutions. Analyze counterparty risk exposures related to cash and bank balances. Operational Efficiency & Projects: Assist with project management, process improvement programs (e.g., RFPs, accounts/services rationalization), and implementing technology to enhance cash management and reporting functions. Audit and Compliance Support: Provide comprehensive operational support for all internal and external audits, SOX compliance controls, and state regulatory examinations, ensuring all processes are documented. Banking Relations: Serve as an important operational interface with external banking partners to resolve daily issues, manage service levels, and support routine operational tasks. Record Management and Governance: Responsible for managing all official records and documentation for Treasury Operations (e.g., debt indentures, banking agreements, fee invoices) within the shared file structure. Manage the Treasury Calendar of Events to track critical due dates for reports, payments, compliance filings, and renewals. Requirements: Experience: 5+ years of progressive, hands-on experience in Corporate Treasury, Cash Management, or Treasury Operations within the financial services or insurance industry. Functional Expertise: 3+ years directly managing corporate liquidity, daily cash positioning, and detailed cash flow reporting/forecasting processes. Operational Systems: Operational experience using major online bank portals (e.g., CashPro, JPM Access, WF Vantage) and managing daily fund movements and settlements. Communication & Theory: Strong communication and presentation skills with the ability to articulate financial concepts. Must understand core Treasury Operations and cash management principle Education: Bachelor's degree in Finance, Accounting, Economics, or a related quantitative field. Bonus points: Prior experience in Treasury Operations within an insurance or healthcare company. MBA and/or CTP certification is preferred. CFA designation is a plus Experience with ERP systems (e.g., Workday) and investment accounting/reporting systems (e.g., Clearwater) for data extraction and analysis; proficiency with Google Suite (Sheets, Docs, Drive) for collaboration and record management is a plus. 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. 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 Privacy Policy.

Hi, we're Oscar. We're hiring a Senior Data Scientist to join our Data 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 Senior Data Scientist, Advanced Risk Modeling, is a senior individual contributor role focused on utilizing advanced machine learning (ML) and artificial intelligence (AI) methodologies on modern ML platforms. This role will build and deploy sophisticated models to help solve complex business problems specifically within Oscar's risk adjustment domain. You will report into the Director of Data. Work Location: This is a remote position, open to candidates who reside in: San Francisco, CA. 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: $158,400- $207,900 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants, and annual performance bonuses. Responsibilities: Conduct in-depth data analysis and advanced feature engineering using large, complex healthcare datasets to create robust predictors. Design, develop, and validate advanced ML/AI models (e.g., regression/classification, deep learning, NLP, gradient boosting, LLM experimentations) to solve complex clinical and business problems within the risk adjustment domain. Leverage modern ML Ops platforms (e.g., Vertex AI) and data science best practices to efficiently train, test, deploy, and maintain production-level models. Build and maintain the supporting data systems, analytics, and monitoring infrastructure required for complex, production-level AI/ML systems. Research, develop, and evaluate new AI applications using cutting-edge techniques, including LLM models and agentic frameworks, to solve critical business challenges in risk adjustment. Work closely with business stakeholders, engineering teams, and product managers to gain a deep understanding of business operations and technical systems. Build strong partnerships to foster close, effective integrations between data science, engineering, product, and business units. Partner with leaders to identify high-impact opportunities, translate complex business challenges into data science solutions, and ensure successful model implementation within business workflows. Requirements: 4+ years of industry or other quantitative technical fields (which may include academia). 3+ years of work experience working with SQL, R, and/or Python to query, manipulate and analyze data 3+ years experience building data models, using more advanced analytics methods, statistical modeling, and/or data processing Bonus points: Advanced degree in a quantitative or technical field Experience in the healthcare, finance and/or insurance industries 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. 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 Privacy Policy.

Job Description Hi, we're Oscar. We're hiring an Associate to join our Network Contracting & Services 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, Network Contracting & Services is responsible for managing contracts with key healthcare providers in Oscar's network (hospital/health systems and individual provider groups) to build and maintain a robust network in assigned market/region; while also ensuring access to quality care and optimizing costs by analyzing provider performance and negotiating reimbursement rates, often involving complex contract terms and compliance with regulatory guidelines. The Associate also supports network growth and recruiting efforts by engaging with prospective providers directly; assisting with resolution of provider issues; supporting cost- saving initiatives; executing the local network strategy; and ensuring providers across our service area have the information and support they need to provide best-in-class member care. You will report into the Senior Manager, Network Contracting. Work Location: This is a remote position based in the field, open to candidates who reside in Florida. Your daily work will involve a blend of work from your home office and travel for client meetings. Occasional travel may be required for team meetings and company events. #LI-Remote Travel up to 25% Pay Transparency: The base pay for this role is: $88,560 - $116,235 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Implement contracting strategies under the direction of Network Director and/or Senior Manager and in partnership with Market Leaders that align with the company's overall network adequacy, development and cost management objectives. Manage and negotiate contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards and regulatory requirements. Supports comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization. Utilizes data and analytics of provider financial issues and competitor strategies to support informing negotiation and contracting decisions. Meet defined metrics and SLAs including but not limited to provider outreach and contract completion. Collaborate with the provider services team regarding the servicing, education and communication to our provider network. Monitor assigned networks to gauge compliance with standards, developing corrective action plans with network contracting and market leadership to remediate deficiencies. Compliance with all applicable laws and regulations Other duties as assigned Requirements: 3+ years of experience in healthcare client management, healthcare consulting, or provider healthcare contracting, healthcare operations, or a related field 2+ years of experience supporting provider network strategy development and negotiating provider contracts 1+ years experience running financial analyses on a markets or product lines, and working cross-functionally to support driving improvement opportunities 1+ years experience navigating and organizing large data sets such as claim files and provider rosters Bonus points: Associate's degree or equivalent professional working experience 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. 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 Privacy Policy.

Hi, we're Oscar. We're hiring an Associate to join our Payment Integrity 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: This role is responsible for supporting process improvement and issue resolution in the Oscar claim environment for both the Oscar Insurance business and +Oscar clients. The Associate, Payment Integrity is responsible for ensuring claims are paid accurately and timely with the highest quality. This is accomplished by leveraging a deep understanding of Oscar's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement. The Associate provides thought leadership for Payment Integrity process and workflows that impact claims payments and works closely with cross functional partners on execution of changes. You will report into the Sr. Manager, Payment Integrity. Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah.. 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: $79,920 - $104,895 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Provide subject matter expertise and in-depth understanding of Payment Integrity internal claims processing edits, external vendor edits and Oscar reimbursement policies. Identify claims payment issues from data mining, process monitoring, etc., provide scoping and action steps needed to remediate the issue. Respond to internal and external inquiries and disputes regarding policies and edits. Document industry standard coding rules and provide recommendations on reimbursement policy language and scope. Ideate payment integrity opportunities based on a deep knowledge of industry standard coding rules. Translate into business requirements; submit to and collaborate with internal partners to effectuate change. Provide training and education to team members when necessary. Perpetuate a culture of transparency and collaboration by keeping stakeholders well informed of progress, status changes, blockers, completion, etc.; field questions as appropriate. Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc. whenever issues are escalated and assigned by leadership. Compliance with all applicable laws and regulations Other duties as assigned Requirements: A bachelor's degree or 4+ years of commensurate experience 4+ years of experience in claims processing, coding, auditing or health care operations 4+ years experience in medical coding Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA) Experience with reimbursement methodologies, provider contract concepts and common claims processing/resolution practices. 3+ year(s) ability to work independently to drive projects to completion Bonus points: 3+ years experience in a technical role (QA analyst, PM, operations analyst, finance, consulting, industrial engineering) or a process improvement role (Six Sigma or similar) 3+ years of experience working with large data sets using excel or a database language Experience in a professional healthcare claims organization Knowledge management, training, or content development in operational settings Process Improvement or Lean Six Sigma training Experience using SQL 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. 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 .

Hi, we're Oscar. We're hiring a Senior Manager, Actuarial to join our Actuarial. 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 Senior Manager, Actuarial leads a team of analysts and is responsible for pricing of several ACA markets. The Senior Manager is a critical partner to Market P&L, Insurance Product, and other analytic support functions for consultation of regional specific pricing, network and product strategy. They also oversee the end-to-end regulatory submission, will understand risks underlying their markets, and will ensure pricing is actuarially sound. You will report into the Associate Director, Actuarial. 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. #LI-Remote Pay Transparency: The base pay for this role is: $158,400 - $207,900 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Lead team programs to enhance pricing models and methodologies. Oversee the end-to-end rate development within a specific region for Oscar's ACA markets. Influence and collaborate with key stakeholders to guide strategic decisions concerning rates. Have an in-depth understanding of key financial risks and opportunities within each of your markets and more broadly across ACA -- and apply those learnings to guide analytical pricing, prospective pricing strategy, SAE considerations, network strategy, and other unique mitigation strategies. Provide an actuarial viewpoint across cross-functional teams for Oscar's ACA-compliant Individual and Small Group markets as we rapidly grow in existing and new markets. Mentor, coach, and provide pricing analysts with regular feedback. Promote and shape Oscar actuarial best practices with respect to automation and documentation. Maintain relationships, partnership, and lines of communication with both internal and external stakeholders. Compliance with all applicable laws and regulations Other duties as assigned Requirements: College degree in a STEM field. Associate or Fellow of the Society of Actuaries (SOA), or on the track to become one. 7+ years of quantitative analysis experience. Bonus points: Excellent communication, collaboration, and relationship-building skills. Strong understanding of health insurance concepts and nuances. 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. 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 Privacy Policy.

Hi, we're Oscar. We're hiring a Provider Network Associate to join our Contracting 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 Provider Network Associate supports the overall accessibility, availability and quality of Oscar's Provider Network through the execution of specific network development functions. This role will work in concert with various internal partners and existing and future external provider partners to meet market growth, network quality and medical costs targets. This role will support the provider recruitment, engagement and education function within the Network Management pillar of Oscar's Insurance Operation function. You will report into the Senior Manager, Network Development Work Location: This is a remote position based in the field, open to candidates who reside: Alabama, Florida, Illinois, Iowa, Kansas, Michigan, Mississippi, Missouri, Nebraska, North Carolina, Ohio, Texas. Your daily work will involve a blend of work from your home office and frequent travel for client meetings. #LI-Remote Travel requirement up to 75% Pay Transparency: The base pay for this role is: $84,240 - $110,565 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Leverage available demographic data for current out of network providers to target recruiting for network adequacy needs based on geography, specialty, or member demographics. Deploy recruiting activities in defined expansion regions based on population demographics, healthcare needs, and competitor presence Assess potential provider capabilities, workflows and staffing to ensure ability to adhere to access standards and meet quality of care requirements. Help develop targeted outreach strategies to attract high-quality providers in desired specialties and locations. Perform daily outreach and contact with potential providers through phone calls, emails, and in-person meetings to present the benefits of joining the network. Document provider outreach activities and manage provider data in a Customer Relationship Management (CRM) system. Pitch the network to prospective providers and guide new providers through the process of joining the network. Participate in process improvement initiatives to optimize workflows and enhance provider experience. Compliance with all applicable laws and regulations Other duties as assigned Requirements: Bachelors Degree or 4+ years of relevant experience 3+ years of experience in provider healthcare recruiting and contracting 1+ years experience in provider relations, provider services or provider recruiting, and working cross-functionally to drive growth and expansion in one or more geographical areas Bonus points: Experience with Customer Relationship Management (CRM) systems in a healthcare environment Experience in credentialing function and credentialing software 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. 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 .

Hi, we're Oscar. We're hiring a Director, Medical Economics - Corporate to join our Actuarial. 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 Director, Medical Economics - Corporate acts as a specialized internal consultant and narrative architect within the Medical Economics function. Reporting directly to the Senior Director, Medical Economics - Corporate, this leader focuses less on the technical construction of budgets and more on the synthesis, interpretation, and communication of medical cost trends. While the Senior Director serves as the strategic anchor for financial planning, the Director plays an important role in Quarterly Earnings support and Executive Reporting. You will bridge the gap between technical Actuarial teams and Corporate Finance/Investor Relations, translating complex data into the "company story" for the Board of Directors, executive leadership, and external analysts. You will report into the Senior Director, Medical Economics. Work Location: This is a remote position, open to candidates who reside in: Dallas, TX. 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: $172,800 - $226,800 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses. Responsibilities: Strategic Narrative & Internal Consulting (35%) Be the primary "translator" of medical economic results for non-technical partners, converting raw actuarial data into cohesive business narratives that explain the "why" behind cost trends. Be the internal consultant to Corporate Finance, providing rapid-response insights on emerging risks and opportunities to support decision-making at the Management Committee level. Partner with Investor Relations to ensure consistency in financial messaging and external guidance. Quarterly Earnings Cycle Management (30%) Lead the development of medical economics content for quarterly earnings, including drafting scripts, preparing Q&A talking points for the C-suite, and synthesizing key performance drivers. Collaborate with analytical leads to distill complex quarterly performance data into clear takeaways for analyst calls. Executive & Board Reporting (25%) Lead the creation and delivery of high-impact presentations for the Board of Directors and Operating Committee, focusing on visualizing data to highlight performance drivers. Design reporting packages that succinctly summarize variance analysis and long-term outlooks, ensuring senior leadership has actionable views on medical expense performance. Forecasting and Team Leadership (10%) Support the Senior Director in the corporate budgeting process by pressure-testing assumptions and validating the narrative understanding of the long-term financial outlook. Mentor analysts in developing "soft skills," specifically regarding business writing, data visualization, and stakeholder influence. Requirements: Bachelor's degree in a STEM field, or 4 years commensurate experience. 8+ years of quantitative analysis in the healthcare industry. 3+ years of collaborating and influencing the Executive Leadership Committee. Proven experience in medical economics, corporate strategy, or a related analytics-driven leadership role. Bonus points: Exceptional business writing and storytelling skills; ability to simplify complex actuarial concepts for executive audiences. Strong familiarity with ACA-specific healthcare dynamics and how they impact external financial reporting. Previous experience in management consulting or internal corporate strategy is highly desired. Fellow of the Society of Actuaries (SOA), or on the track to become one. 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. 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 Privacy Policy.

Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management 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: You will determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines. Hours: 8am - 5pm in your local time zone Call rotation - 1 weekend every 16 weeks You will report into the Associate Medical Director, Utilization Management. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $211,200 - $ 277,200 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation, and annual performance bonuses. Responsibilities: Provide timely medical reviews that meet Oscar's stringent quality parameters. Provide clinical determinations based on evidence-based criteria and Oscar internal guidelines and policies, while utilizing clinical acumen. Clearly and accurately document all communication and decision-making in Oscar workflow tools, ensuring a member could easily reference and understand your decision (Flesch-Kincaid grade level). Use correct templates for documenting decisions during case review. Meet the appropriate turn-around times for clinical reviews. Receive and review escalated reviews. Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research. Compliance with all applicable laws and regulations Other duties as assigned Requirements: Board certification as an MD or DO Licensed in FL or NC and/or active Interstate Medical Licensure Compact (IMLCC) or eligible to apply for IMLCC. 6+ years of clinical practice 1+ years of utilization review experience in a managed care plan (health care industry) Bonus points: Licensure in multiple Oscar states BC in Cardiology, Radiation/Oncology, or Neurology Experience with care management within the health insurance industry. Willing and able to obtain additional state licensure as needed, with Oscar's support 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. 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 Privacy Policy.

Job Description Hi, we're Oscar. We're hiring an Associate, Itemized Bill Review to join our Payment Integrity 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, Payment Integrity, Itemized Bill Review (IBR) will be responsible for executing internal payment integrity solutions requiring billing and coding expertise with and continual improvement and development of the solutions. You will ensure claims are paid accurately and timely with the highest quality. This is accomplished by leveraging a deep understanding of Oscar's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement. You will report into the Manager, Payment Integrity (Pre-Pay). Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah. 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: $79,920 - $104,895 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities: Perform line-by-line review of high-dollar facility itemized bills and corresponding claim forms (e.g., UB-04s) Proactively identify and document potential billing errors, including duplicate billing of items, services, or procedures as improper unbundling of services (e.g., separating components that should be billed together) and charges for non-covered or non-rendered services Compare billed charges against both payor-specific contracts and industry guidelines to confirm appropriate billing practices. Apply working knowledge of national coding systems (e.g., CPT, HCPCS, ICD-10, MS-DRGs) to validate the accuracy of codes used for services billed. Review claims eligible under specific reimbursement scenarios: a percentage of charges or those exceeding stop-loss levels, ensuring the claim exceeds the minimum dollar threshold set by the payor Prepare clear, concise, and professional documentation of all findings, including savings identified, policy violations, and recommended claim adjustments Contribute to the refinement of internal audit processes and tools to enhance efficiency and accuracy in identifying claim inaccuracies Serve as a subject matter expert for internal and external stakeholders regarding complex billing issues, coding guidelines, and payor policies Provide subject matter expertise and in-depth understanding of Payment Integrity internal claims processing edits, external vendor edits and Oscar reimbursement policies Identify claims payment issues from data mining, process monitoring, etc., provide scoping and action steps needed to remediate the issue Respond to internal and external inquiries and disputes regarding policies and edits. Document industry standard coding rules and provide recommendations on reimbursement policy language and scope Ideate payment integrity opportunities based on a deep knowledge of industry standard coding rules. Translate into business requirements; submit to and collaborate with internal partners to effectuate change Provide training and education to team members when necessary Perpetuate a culture of transparency and collaboration by keeping stakeholders well informed of progress, status changes, blockers, completion, etc.; field questions as appropriate Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc. whenever issues are escalated and assigned by leadership Compliance with all applicable laws and regulations Other duties as assigned Requirements: A bachelor's degree or 4+ years of commensurate experience 2+ years of bill / coding audit experience with a focus on hospital or facility billing (UB-04) 4+ years experience in medical coding Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA) Experience with reimbursement methodologies, provider contract concepts and common claims processing/resolution practices Bonus points: 3+ years of experience working with large data sets using excel or a database language Knowledge management, training, or content development in operational settings Process Improvement or Lean Six Sigma training Experience using SQL 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. 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 Privacy Policy.

Hi, we're Oscar. We're hiring an Associate to join our Network Contracting & Services 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, Network Contracting & Services is responsible for managing contracts with key healthcare providers in Oscar's network (hospital/health systems and individual provider groups) to build and maintain a robust network in assigned market/region; while also ensuring access to quality care and optimizing costs by analyzing provider performance and negotiating reimbursement rates, often involving complex contract terms and compliance with regulatory guidelines. The Associate also supports network growth and recruiting efforts by engaging with prospective providers directly; assisting with resolution of provider issues; supporting cost- saving initiatives; executing the local network strategy; and ensuring providers across our service area have the information and support they need to provide best-in-class member care. You will report into the Senior Manager, Network Contracting. Work Location: This is a remote position based in the field, open to candidates who reside in Florida. Your daily work will involve a blend of work from your home office and travel for client meetings. Occasional travel may be required for team meetings and company events. #LI-Remote Travel up to 25% Pay Transparency: The base pay for this role is: $88,560 - $116,235 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Implement contracting strategies under the direction of Network Director and/or Senior Manager and in partnership with Market Leaders that align with the company's overall network adequacy, development and cost management objectives. Manage and negotiate contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards and regulatory requirements. Supports comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization. Utilizes data and analytics of provider financial issues and competitor strategies to support informing negotiation and contracting decisions. Meet defined metrics and SLAs including but not limited to provider outreach and contract completion. Collaborate with the provider services team regarding the servicing, education and communication to our provider network. Monitor assigned networks to gauge compliance with standards, developing corrective action plans with network contracting and market leadership to remediate deficiencies. Compliance with all applicable laws and regulations Other duties as assigned Requirements: 3+ years of experience in healthcare client management, healthcare consulting, or provider healthcare contracting, healthcare operations, or a related field 2+ years of experience supporting provider network strategy development and negotiating provider contracts 1+ years experience running financial analyses on a markets or product lines, and working cross-functionally to support driving improvement opportunities 1+ years experience navigating and organizing large data sets such as claim files and provider rosters Bonus points: Associate's degree or equivalent professional working experience 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. 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 .

Hi, we're Oscar. We're hiring an Associate, Delegate Oversight to join our Compliance 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, Compliance Audit and Monitoring supports the enterprise's compliance program and activities. You will assist in the development of all compliance program activities to ensure understanding of healthcare regulatory requirements. You will assess department compliance to laws, regulations, standards, and their procedures by conducting audit and monitoring activities. You will report into the Sr. Manager, Compliance Audit and Monitoring. 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: $88,560 - $116,235 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Help create a risk-based audit and monitoring plan for the healthcare organization. Review healthcare regulations, including HIPAA, Medicare, and Medicaid regulations to ensure compliance. Conduct assigned audits based on departmental audit plans. Communicate with teams to understand their business operations and test their compliance with regulations. Evaluate compliance effectiveness and identify areas for improvement. Draft and complete accurate audit reports, ensuring that the audit findings and conclusions are communicated clearly to the business unit. Help identify compliance gaps and risks, and contribute to the development of proactive strategies to address them. Help maintain compliance policies, procedures, and controls in alignment with regulatory requirements. Provide regular updates to leadership on compliance audit and monitoring activities, findings, and recommendations. Compliance with all applicable laws and regulations Other duties as assigned Requirements: Bachelor's Degree or equivalent work experience 2+ years experience working in health care or related field 2+ years experience in health plan compliance 2+ years driving compliance with regulatory and accreditation audit/policy requirements 2+ years experience working with regulation and translating into operational procedures 2+ years experience / background in a fast-paced environment Bonus points: Certification in Healthcare Compliance (CHC), Certified Compliance and Ethics Professional CCEP, or similar Fluency with State DOI audit and/or reporting obligations State DOI audit management experience Experience in a start-up and/or health tech environment Experience in a TPA setting 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. 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 Privacy Policy.

Hi, we're Oscar. We're hiring an Associate, Actuary to join our Actuarial 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, Actuarial supports pricing for several ACA markets and leads efforts to maintain pricing and plan design modeling. The Associate is a critical partner to Market P&L, Insurance Product and other Analytic support functions for consultation of regional specific pricing, network and product strategy. They also support the regulatory submission process, support plan design compliance, and will ensure pricing is actuarially sound. You will report into the Associate Director, Actuarial. 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: $102,240 - $134,190 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Maintain core pricing and plan design models. Ensure consistency and standardization across team users. Important contributor in developing and submitting regulatory filings, and developing a viewpoint and recommendation for strategic pricing decisions. Provide an actuarial viewpoint across cross-functional teams for Oscar's ACA-compliant Individual and Small Group markets as we grow in our markets. Promote and shape Oscar actuarial best practices concerning automation and documentation. Maintain relationships, partnership, and lines of communication with both internal and external stakeholders. Aid in the onboarding of analysts by collaborating and integrating them into existing processes. Compliance with all applicable laws and regulations Other duties as assigned Requirements: College degree in a STEM field. Associate or Fellow of the Society of Actuaries (SOA), or on the track to become one. 4+ years of quantitative analysis experience. Bonus points: Excellent communication, collaboration, and relationship-building skills. Strong understanding of health insurance concepts and nuances. 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. 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 Privacy Policy.