Senior Manager, Network Performance
About The Position
The Senior Manager, Network Performance leads the analytical execution and operationalization of Oscar’s Value-Based Care (VBC) strategies. While supporting the broader network performance and analytics roadmap, this role specifically focuses on designing, modeling, and monitoring alternative reimbursement models—ranging from shared savings to full capitation. As a key partner to Network, Actuarial, and Finance stakeholders, the Senior Manager brings technical rigor to economic modeling and contract valuation. This role is accountable for measuring the performance of VBC arrangements and driving actionable insights that support Oscar’s total cost of care (TCoC) and affordability goals. You will report into the VP, Medical Economics.
Requirements
- Bachelor's degree in a STEM field.
- 7+ years of relevant quantitative analysis experience.
- Proven experience in health insurance / payer analytics, with an understanding of medical claims data (e.g., CPT/HCPCS, ICD-10, DRGs) and standard healthcare industry data sources.
Nice To Haves
- Associate or Fellow of the Society of Actuaries (SOA), or on the track to become one.
- Excellent communication, collaboration, and relationship-building skills.
- Experience developing measurement of clinical intervention ROI.
- Knowledge of prior authorization optimization and automation.
- Familiarity with pharmacy economics.
- Background in value-based care analytics.
- Experience translating between clinical, business, and analytic vocabularies.
Responsibilities
- VBC Strategy Execution — Execute against the Network Performance strategy by developing robust frameworks to evaluate and monitor Value-Based Care arrangements, ensuring alignment with enterprise medical economics and TCoC goals.
- Modeling & Deal Structuring — Lead the design and maintenance of advanced models that forecast VBC deal performance, calculate settlement outcomes (shared risk/savings), and assess the financial impact of capitated arrangements.
- Cross-Functional Partnership — Partner closely with Network Contracting, Clinical, and Actuarial teams to structure sustainable VBC contracts and inform negotiation strategies with data-driven risk assessments.
- Methodology Development — Develop and refine methodologies for benchmarking provider performance, attributing populations, and setting financial targets for risk-based arrangements, ensuring transparency and analytical rigor.
- Insight Generation — Translate complex VBC performance data into clear, strategic recommendations for leadership to optimize existing arrangements and identify new opportunities for payment innovation.
- Team Leadership — Manage and mentor a team of analysts; foster a culture of technical excellence, accuracy, and ownership over VBC analytical outputs.
- Technical Bridge — Serve as the technical lead ensuring that VBC analytical work connects directly to business outcomes and financial reporting.
- Trend Monitoring — Monitor VBC market trends, regulatory changes in reimbursement, and provider risk appetite to continuously improve Oscar’s modeling approaches.
- Compliance with all applicable laws and regulations
- Other duties as assigned
Benefits
- employee benefits
- participation in Oscar's unlimited vacation program
- annual performance bonuses
- medical, dental, and vision benefits
- 11 paid holidays
- paid sick time
- paid parental leave
- 401(k) plan participation
- life and disability insurance
- paid wellness time and reimbursements
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
