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ManagerFull-timeAWSAI
Salary Range
$81,600 - $110,400 /year
This salary is estimated based on similar roles. The actual salary may vary.
About the Role
We are looking for a UM Program Operations Manager to join our UM Strategy team at Oscar Health. This role is the "Execution Engine" of the UM Strategy team, responsible for the flawless execution of high-impact programs like Gold Carding, Provider Incentive Programs, and the maintenance of our Prior Authorization (PA) List.
Key Responsibilities
- →Lead the end-to-end execution and refresh cycles for "Gold Card" and "Provider Incentive" programs, managing provider entry/exit criteria and coordinating clinical audit frameworks.
- →Act as the primary owner of the "Source of Truth" for the Prior Authorization list, ensuring code additions, removals, and modifications are clinically adherent and accurately reflected across all systems.
- →Ensure all UM programs meet state and federal mandates, including emerging "Gold Card" legislation and transparency requirements.
- →Develop and maintain Standard Operating Procedures (SOPs) for net-new initiatives.
- →Drive recurring refresh cycles for auto-approval rules and provider incentive programs.
- →Lead the end-to-end management of cross-functional implementations/projects, including project plan creation and stakeholder engagement.
- →Evaluate departmental performance by creating, gathering, analyzing, and interpreting data and metrics.
- →Collaborate with internal and external stakeholders to formulate proactive implementation, communications, and program strategies.
- →May oversee team members directly and mentor team members to promote professional development.
Requirements
- ✓4+ years of experience in program management
- ✓3+ years of experience in delivering projects/programs
- ✓2+ years of experience in managing prior authorization list process
- ✓Experience in payer/health insurance
Benefits
- ★Unlimited vacation program
- ★Annual performance bonuses
- ★Medical, dental, and vision benefits
- ★11 paid holidays
- ★Paid sick time
- ★Paid parental leave
- ★401(k) plan
- ★Life and disability insurance
- ★Paid wellness time and reimbursements
