Sr. Analyst, Authorization Services Design & Configuration

Oscar Health•Tempe, AZ

8h•Hybrid

About The Position

You will be the architect of our medical management operations. In this role, you will design, configure, and optimize the workflows and business rules within our Utilization Management (UM) system to ensure seamless authorization processing. You will translate complex business requirements into automated logic, handle internal escalations to identify root causes and remediation pathways, and act as a subject matter expert to educate cross-functional partners on how our systems drive care decisions. This is a technical and operational role that requires a systems thinker with a collaborative mindset who enjoys solving complex, systems level problems. You will report into the Associate Director of Authorization Services.

Requirements

2+ years of experience in system configuration, business rules management, or technical workflow design.
2+ years of experience in a technical/operational role involving root-cause analysis and data troubleshooting.
Intermediate to Advanced proficiency in Excel/Google Sheets (vlookups, pivot tables, and data manipulation).
Proven ability to assess and comprehend end-to-end process impacts in complex technical environments.
Strong communication skills with the ability to explain technical system logic to non-technical stakeholders.
1+ year working knowledge of within the healthcare industry (payer or provider).

Nice To Haves

Prior work experience in Prior Authorizations or Insurance Operations.
2+ years of proficiency in SQL, BigQuery, or similar database languages.
Experience using project management and communication tools like JIRA, Linear, and Slack.
Experience working with large datasets, data verification, and data management.

Responsibilities

Manage the configuration and maintenance of authorization workflows, rulesets, and automations within the UM platform.
Translate business requirements into precise technical specifications, ensuring that business rules and logic are accurately represented, tested, and implemented.
Investigate and resolve cross-functional escalations by performing root cause analysis on system behavior and configuration gaps.
Proactively identify "friction points" in the authorization process and document formal opportunities for workflow improvement and automation.
Act as the primary subject matter expert for the UM system, educating internal teams (Product, Clinical, Regulatory) on how configuration impacts operations and supports business needs.
Develop testing protocols and execute test scenarios to validate expected system behavior and configuration accuracy. Lead corrective activities when system behavior deviates from expectations.
Manage assigned caseloads and project tasks through effective dashboard management and prioritization.
Maintain clear, comprehensive documentation of all business rules, technical specs, and workflow designs.
Other duties as assigned