Jobs at Oscar Health

Design and ship ICHRA-focused employer contribution tools within the Lucie Marketplace. Collaborate with PMs, engineers, researchers, and stakeholders from discovery through high-fidelity delivery. Conduct user research and usability testing, contribute to the design system, and deliver visually compelling, accessible enterprise product experiences.

Lead design, development, and operation of cloud infrastructure and SRE-focused systems. Own medium-to-large infrastructure projects, build resilient platforms, and drive cross-team technical delivery. Mentor engineers, define SLOs, reduce failure domains, and build tooling for automated, secure CI/CD and production reliability.

Supports payment integrity through claims research, coding and reimbursement policy expertise, issue resolution, root cause analysis, process improvement, and business requirements development. Investigates claim outcomes, evaluates internal and vendor edits, identifies opportunities using data and process monitoring, and collaborates with stakeholders to implement solutions. The role also responds to policy disputes, supports escalated issues, and ensures regulatory compliance.

Supports provider network development for a health insurer by recruiting, engaging, and educating providers; targeting network adequacy needs; assessing provider capabilities; conducting outreach and meetings; maintaining CRM data; guiding providers through network participation; and improving workflows while ensuring regulatory compliance. The role is remote but field-based and requires travel of up to 75%.

Manages provider operations teams, including coaching, hiring, performance management, KPI reporting, data analysis, root-cause analysis, process improvement, change management, and risk mitigation. Partners with stakeholders to improve productivity, client satisfaction, operational efficiency, and compliance while ensuring team outputs meet departmental objectives.

Investigate and verify coordination of benefits for medical and pharmacy claims, conduct payment integrity audits, and identify reimbursement opportunities. The role develops and improves COB workflows, analyzes claims data, performs root-cause research, translates findings into business requirements, collaborates with stakeholders, responds to policy inquiries, and supports training and issue resolution while ensuring regulatory compliance.

Manage end-to-end coordination of benefits and payer eligibility data to support accurate claims processing. Initiate recovery of overpaid claims, contact providers regarding findings and disputes, document recovery activities, and escalate questions as needed. The role also supports prioritization and solution delivery, maintains regulatory compliance, and requires familiarity with healthcare claims, medical billing, insurance regulations, and spreadsheet tools.

Manage and negotiate provider contracts for assigned Texas/West markets to build and maintain network adequacy. Analyze provider performance and costs, support network growth and recruiting, resolve provider issues, ensure regulatory compliance, collaborate with provider services, and meet SLAs and metrics.

Manages and negotiates healthcare provider contracts across an assigned region, supporting network growth, regulatory compliance, reimbursement optimization, and cost-saving initiatives. Analyzes provider performance, financial data, claims, and rosters to inform contracting decisions. The role also supports network strategy, provider issue resolution, corrective action plans, process improvements, provider communications, and mentorship of junior team members. Travel may comprise up to 25% of the position.

Leads healthcare network contracting for a defined region, including complex provider negotiations, contract analysis, settlement resolution, regulatory compliance, and network optimization. Manages contracting staff, develops strategies aligned with network adequacy and cost goals, monitors performance metrics, resolves provider issues, and maintains relationships with hospitals, health systems, and national providers.

Supports value-based healthcare contracting by negotiating provider agreements, analyzing provider performance and financial data, ensuring regulatory compliance, growing provider networks, resolving provider issues, and implementing network strategy and cost-saving initiatives. The role also mentors junior staff, monitors network adequacy, supports process improvements, and collaborates with provider services teams. It is remote within specified states and requires frequent local travel for client meetings.

Reviews high-dollar facility bills and claims line by line to identify billing errors, coding issues, improper bundling, and non-covered services. Applies coding systems, reimbursement methodologies, contracts, and payer policies to validate claims and recommend adjustments. Documents savings and findings, supports payment integrity edits, analyzes payment issues, contributes to process improvements, develops business requirements, resolves inquiries, and provides subject matter expertise and training.

Lead execution of insurance product lifecycle overseeing regulatory filing, quality assurance, and operational governance. Collaborate with cross-functional teams and vendors to ensure compliance and effective product implementation.

The role involves driving innovation in insurance product development, managing pilot programs, and collaborating across teams to enhance healthcare solutions.

Develops market-level strategies for growth, retention, competitive positioning, expansion, and portfolio optimization across health insurance markets. Leads market-entry analyses, business cases, strategic initiatives, and multi-year planning while evaluating competitive, provider, regulatory, and financial dynamics. Translates complex market intelligence into executive-ready recommendations and partners with cross-functional leaders to support strategic decision-making and execution.

Support payment integrity disputes and issue resolution for claims. Scope, triage, investigate, and implement process improvements. Translate claim infrastructure and stakeholder friction into business requirements, collaborate cross-functionally, perform root cause analysis, and provide training and documentation to reduce adverse claim outcomes and improve reimbursement accuracy.

The Senior Director, Markets Strategic Advisory & Intelligence leads market strategy and analytics for product development, overseeing research, performance assessments, and strategic recommendations to support market expansion and optimize the product portfolio.

The Manager, Insurance Product Market Research conducts market research, analyzes health trends, and provides strategic insights to support product strategy and decisions.

Support ACA market pricing and plan design modeling, produce regulatory filings, provide actuarial guidance across cross-functional teams, maintain pricing models and documentation, and onboard analysts to ensure actuarially sound pricing.

The Senior Manager, Insurance Product Intelligence will lead intelligence programs, support strategic decision-making, and improve product performance through market insights and analysis.