Analyst, Authorization Services Design & Configuration

Hi, we're Oscar. We're hiring a Sr. Analyst, Authorization Services Design & Configuration to join our 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:

You will be the architect of our medical management operations. You will design the workflows and business rules within our Utilization Management (UM) system to ensure seamless authorization processing. You will translate complex requirements into automated logic. You will handle internal escalations to identify causes and remediation pathways. As a subject matter expert, you will act to educate cross-functional partners on how our systems guide care decisions.

We are looking for a systems thinker with a collaborative mindset who enjoys solving complex, systems level problems.

You will report into the Associate Director, UM Optimization.

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: $67,813 - $89,005 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

• Manage the configuration and maintenance of authorization workflows, rulesets, and automations within the UM platform.
• You will translate business requirements into precise technical specifications, ensuring that business rules and logic are accurately represented, tested, and implemented.
• Investigate and resolve escalations by performing root cause analysis on system behavior and configuration gaps.
• You will Identify "friction points" in the authorization process and document formal opportunities for workflow improvement and automation.
• Be the primary subject matter expert for the UM system, educating other teams (Product, Clinical, Regulatory) on how configuration impacts operations and supports our needs.
• Develop testing protocols and implement test scenarios to validate expected system behavior and configuration accuracy. Lead corrective activities when system behavior deviates from expectations.
• Manage assigned caseloads and project tasks through dashboard management and prioritization.
• Maintain clear, comprehensive documentation of all business rules, technical specs, and workflow designs.