Associate, Medical Economics

Hi, we're Oscar. We're hiring an Associate, Medical Economics to join our Data team.

Oscar is the first health insurance company built around a full stack technology platform and a 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

As the Associate, Medical Economics, you will be responsible for understanding cost and utilization trends in your assigned market(s), with a relentless focus on identifying top trend drivers and proactively spotting emerging cost flares. You will combine technical expertise with creative solutioning to help shape and scope new total cost of care (TCoC) opportunities, leveraging deep domain expertise pertaining to your market.

The Associate, Medical Economics will collaborate with analytical leaders across Finance and Data Science and business leaders across Clinical and Market P&L to segment and analyze claim data, including sizing opportunities to reduce avoidable spend, measuring and monitoring outcomes, and quantifying return on investment (ROI) of affordability initiatives.

You will report to the Associate Director, Data Analytics.

Work Location:

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.

If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.

You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

Pay Transparency:

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $98,400 - $129,150 per year. The base pay for this role in all other locations 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

• Serve as the data lead for one of Oscar's major ACA markets, analyzing cost and utilization trends to identify key drivers and uncover root causes of emerging developments.
• Build, maintain, and enhance KPI frameworks to closely monitor financial performance, proactively detecting emerging signals or deviations from expected results.
• Conduct deep-dive analyses of performance flares, identify root causes, and present findings to both analytical and operational leadership with actionable insights.
• Leverage creative problem-solving and technical expertise to shape and scope new affordability opportunities based on deep market knowledge.
• Measure and monitor the outcomes of TCoC initiatives, including ROI quantification.
• Create models and tools that generate insights to detect healthcare inefficiencies and recommend actions to mitigate them.
• Effectively communicate complex information clearly and concisely, both in written reports and verbal presentations, to leadership and key stakeholders.
• Other duties as assigned.

Qualifications

• 3+ years of technical work experience using analytical tools and writing analytical reports
• 2+ years demonstrated ability to work with large datasets and distill analyses into relevant insights with a structured and systematic thought process
• Strong verbal and written communication skills with leadership around business reporting impact and requirements
• 2+ years experience in SQL, with the ability to filter, aggregate, and build CTEs, or proficiency in R or Python, including experience with Pandas, for loops, and statistical tests
• 1+ years experience, including proficiency in Google Sheets or Excel skills,  with ability to use VLookup, nested if statements and connected Sheets
• 1+ years experience in healthcare, finance or the insurance industry

Bonus Points

• Bachelor’s degree in a STEM field, or 4 years commensurate experience.
• 2+ years of experience in preparing healthcare analytics and reporting
• 2+ years of economics experience in the healthcare industry
• 2+ years of experience developing dashboards and working with Looker or other business intelligence/data visualization tools
• 2+ years experience managing value-based contracts at a payer or a provider organization (ACO, CIN, MSO etc.)  
• Strong familiarity with ACA-specific healthcare laws, regulations, and compliance requirements.

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.

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 Notice to Job Applicants.