Senior Manager, Network Performance

Oscar Health; Remote; USD 147,000 - 194,000; Full time

Job summary

A leading health insurance company is seeking a Senior Manager, Medical Economics to spearhead Value-Based Care strategies. This remote role involves developing models, partnering with various departments, and ensuring data-driven decision-making. Candidates must hold a Bachelor's degree in a STEM field and have over 7 years of relevant experience in quantitative analysis within health insurance. This position offers attractive benefits and an emphasis on fostering a supportive environment.

Benefits

Unlimited vacation program

Annual performance bonuses

Medical, dental, and vision benefits

401(k) plan participation

Qualifications

• 7+ years of relevant experience in quantitative analysis.
• Experience with medical claims data and healthcare industry data sources.
• Proven ability to develop financial modeling and deal structuring.

Responsibilities

• Lead the execution of VBC strategies and frameworks.
• Design advanced models to forecast VBC performance.
• Generate strategic recommendations from VBC data.

Skills

Quantitative analysis

Health insurance analytics

Communication skills

Collaboration

Education

Bachelor's degree in a STEM field

Job description

Hi, we're Oscar. We're hiring a Senior Manager, Medical Economics to join our Medical Economics team.

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

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.

Work Location

This is a remote position, open to candidates who reside in: Boston, MA. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area.

Pay Transparency

The base pay for this role is: $147,549 - $193,658 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Primary Duties And 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

Required Experience And Education

• 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.

Preferred Experience And Education

• 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.

This is an authentic Oscar Health job opportunity.

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.

Artificial Intelligence (AI)

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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 ([e-mail]) to make the need for an accommodation known.

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