Director, Medical Economics Tooling & Reporting

Job Description

Job Description

Hi, we're Oscar. We're hiring a Director, Medical Economics Tooling & Reporting to join our Medical Economics.

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 Director, Medical Economics Tooling & Reporting, plays an instrumental role in Oscar's medical economics operating model. You will be the lead architect and developer of our next generation of analytic tools. This role is for a hands-on technical expert who will personally develop a unified reporting suite to lead Oscar's Medical Economics program, providing transparent, relevant insights into medical cost and utilization drivers. You will be a project lead collaborating with leaders across the Medical Economics team to incorporate their analytic content into the unified reporting suite. You will lead the department's engagement with partners in the data science team to deliver the foundational datasets and infrastructure upon which the reporting suite will be built.

You will report to the Senior Director, Medical Cost Analytics.

Work Location: This position is based in our Tempe, AZ office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid

Pay Transparency: The base pay for this role is: $172,800 - $226,800 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

• Perform hands-on development while providing direction, guidance, and requirements to supporting matrixed resources from other analytic and tech teams.
• Oversee decision-making responsibilities related to the technical design of a unified suite of medical economics reporting and analytic tooling that will be used to lead Oscar's Total Cost of Care (TCoC) efforts.
• Partner with Medical Economics leaders to create a multi-year roadmap for the tooling suite, including creation of a governance process for designing content and analytic methodologies.
• Develop automated dashboards and reports that decompose medical cost trends, highlighting important causes such as unit cost, utilization, mix of services, provider network changes.
• Be the subject matter expert on Oscar's medical claims data, and incorporate key healthcare methodologies (e.g., risk adjustment, episode groupers, case-mix adjustment) into the tooling suite.
• Ensure the tooling suite is designed to include generative AI for insight generation.
• Be the internal consultant, introducing and applying techniques (e.g., predictive modeling, statistical analysis, machine learning) to enhance the sophistication and predictive power of our tooling suite.
• Be the senior mentor and technical guide for analysts across the medical economics team, elevating the team's skills by promoting best practices in analytics and BI development.
• Develop relationships and lines of communication with main partners across the operational departments.
• Represent the medical economics function in cross-departmental forums, contributing to strategic planning.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• Bachelor's degree in a STEM field, or 4 years commensurate experience.
• 10+ years of quantitative analysis in the healthcare industry.
• Demonstrated expertise in designing, building, and deploying business intelligence solutions and reporting tools from the ground up.
• Advanced, hands-on proficiency with data querying and manipulation languages (e.g., SQL, Python) and BI platforms (e.g., Tableau, Looker, and Power BI).
• Experience with health insurance / payer analytics, with an understanding of medical claims data (e.g., CPT/HCPCS, ICD-10, DRGs) and standard healthcare industry data sources.

Bonus points:

• Advanced degree (Master's or PhD) in a quantitative field such as Data Science, Statistics, or Computer Science.
• Experience working with technology teams. Strong understanding of software development best practices as applied to healthcare analytics.
• Experience working with large language models for development and data analysis.
• Experience applying analytic methodologies (e.g., predictive modeling, statistical analysis, machine learning), preferably in a healthcare context.
• Process management skills, with experience streamlining workflows and driving operational efficiency.
• Collaborative and influential leadership style, with experience working across multiple teams and team members.

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 ([email protected]) to make the need for an accommodation known.

Artificial Intelligence (AI) Guidelines : Please see our AI Guidelines for the acceptable use of artificial intelligence during the interview process at Oscar.

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