Senior Manager, Insurance Product and Benefit Design

This is a fully remote position, open to applicants in Arizona, +14 more states.

📋 Description

• Oversee comprehensive plan design across designated regions, incorporating benefits, cost-sharing, and network factors.

• Convert market strategies, performance insights, and regulatory demands into definitive design choices.

• Direct the product lifecycle from initial design to filing, implementation, and evaluation of post-launch performance.

• Act as the product owner for design within the regulatory filing framework, ensuring precision across PBT's, SBC's, and internal systems.

• Foster consensus among actuarial, regulatory, compliance, network, and operational teams.

• Develop and maintain disciplined operating rhythms throughout design and filing cycles, ensuring timely completion of timelines, dependencies, and deliverables.

• Encourage process optimization and standardization across markets to enhance scalability, minimize defects, and accelerate market entry.

• Spearhead continuous improvement initiatives within product design and filing processes, pinpointing inefficiencies and executing sustainable solutions.

• Collaborate to guarantee smooth execution from design through regulatory filing submission, approval, and objection tracking.

• Assess program effectiveness against financial, operational, and provider/member experience objectives.

• Balance standardized plan design frameworks with specific market variations to sustain competitiveness.

• Identify risks and lead the resolution of intricate design and execution challenges.

• Conduct QA and go-to-market readiness evaluations to verify compliant plan designs.

• Analyze market, competitive, and regulatory factors to guide strategy and positioning.

• Mentor junior team members and aid in the development of team capabilities.

• Ensure compliance with all relevant laws and regulations.

• Perform other duties as assigned.

⛳️ Requirements

• Bachelor's degree in business, healthcare, economics, finance, or a related field.

• Over 6 years of experience in health insurance product and ACA/QHP benefit design, with direct accountability for health plan design decisions.

• Understanding of ACA plan design, including cost-sharing frameworks, metal tiers, EHB, and regulatory requirements.

• Proven experience leading regulatory filing processes, including PBT, SBC, and associated documentation.

• Operational experience adhering to structured processes linked to product development and regulatory filing, with the ability to suggest process enhancements for scalability and efficiency.

• Experience working within complex, matrixed organizations.

• Willingness to travel up to 25% of the time.

🏝️ Benefits

• Employee benefits.

• Participation in Oscar's unlimited vacation program.

• Annual performance bonuses.