Note: The job is a remote job and is open to candidates in USA. Oscar Health is hiring a Senior Analyst, Authorization Services Design & Configuration to design and maintain workflows and business rules in its Utilization Management system. The role translates requirements into automated logic, resolves system escalations, and educates cross-functional partners on how system configuration supports care decisions.
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
- Other responsibilities as assigned
Skills
- 2+ years of experience in system configuration, business rules management, or technical workflow design
- 2+ years of experience in a technical/operational role involving root-cause analysis and data troubleshooting
- Intermediate to Advanced proficiency in Excel/Google Sheets (vlookups, pivot tables, and data manipulation)
- Experience assessing and comprehending end-to-end process impacts in complex technical environments
- Strong communication skills with the ability to explain technical system logic to non-technical partners
- 1+ year working knowledge of within the healthcare industry (payer or provider)
- Prior work experience in Prior Authorizations or Insurance Operations
- 2+ years of proficiency in SQL, BigQuery, or similar database languages
- Experience using project management and communication tools like JIRA, Linear, and Slack
- Experience working with large datasets, data verification, and data management
Benefits
- Fully remote position, open to candidates who reside in Dallas, TX; future models could potentially involve a hybrid presence at the hub office associated with your metro area.
- Participation in Oscar's unlimited vacation program
- Annual performance bonuses
- For full-time employees: medical, dental, and vision benefits
- For full-time employees: 11 paid holidays
- For full-time employees: paid sick time
- For full-time employees: paid parental leave
- For full-time employees: 401(k) plan participation
- For full-time employees: life and disability insurance
- For full-time employees: paid wellness time and reimbursements
Company Overview
Company H1B Sponsorship