Remote: Senior Analyst, Authorization Design & Automation

Oscar Health; New York (NY); Remote; USD 68,000 - 89,000; Full time

Benefits offered by this job

Unlimited vacation

Annual performance bonuses

Job summary

Oscar Health is seeking a Sr. Analyst for Authorization Services Design & Configuration. This role focuses on designing the workflows and business rules within our Utilization Management (UM) system to ensure seamless authorization processing.

You will translate complex requirements into automated logic, handle escalations, and educate cross-functional partners on how configurations guide care decisions. This is a remote role with potential hybrid options in your metro area.

Qualifications

• 2+ years of system configuration or business rules management.
• 2+ years in a technical/operational role with root-cause analysis.
• Experience in Excel/Google Sheets with advanced features.
• Strong ability to translate business requirements into technical specifications.
• 1+ year in healthcare payer or provider industry.
• Prior work in Prior Authorizations or Insurance Operations.
• 2+ years in SQL, BigQuery, or similar.

Responsibilities

• Manage configuration and maintenance of authorization workflows and rulesets within the UM platform.
• Translate business requirements into precise technical specifications for implementation.
• Investigate escalations using root cause analysis to identify gaps.
• Identify friction points in the authorization process and propose automations.
• Act as SME for the UM system, educating cross-functional teams on configurations.
• Develop testing protocols and validate system behavior; lead corrective activities.
• Manage caseloads and tasks via dashboards and prioritization.
• Document all business rules, technical specs, and workflow designs.
• Handle other duties as assigned.

Skills

Excel/Google Sheets

SQL/BigQuery

Data troubleshooting

Communication skills

Healthcare domain knowledge

Process mapping

Tools

JIRA

Linear

Slack

Job description

Oscar Health is seeking a Sr. Analyst for Authorization Services Design & Configuration. This role focuses on designing the workflows and business rules within our Utilization Management (UM) system to ensure seamless authorization processing.

You will translate complex requirements into automated logic, handle escalations, and educate cross-functional partners on how configurations guide care decisions. This is a remote role with potential hybrid options in your metro area.