[Hiring] Senior Analyst, Authorization Services Design & Configuration @Oscar Health

Role Description

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

You will be the architect of our medical management operations. Your responsibilities include:

• Designing workflows and business rules within our Utilization Management (UM) system for seamless authorization processing.
• Translating complex requirements into automated logic.
• Handling internal escalations to identify causes and remediation pathways.
• Acting as a subject matter expert 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 is a remote position, open to candidates who reside in Dallas, TX. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

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.
• Translate business requirements into precise technical specifications, ensuring accurate representation, testing, and implementation of business rules and logic.
• Investigate and resolve escalations by performing root cause analysis on system behavior and configuration gaps.
• 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.

Qualifications

• 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 within the healthcare industry (payer or provider).

Bonus points

• 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

• Medical, dental, and vision benefits.
• 11 paid holidays.
• Paid sick time.
• Paid parental leave.
• 401(k) plan participation.
• Life and disability insurance.
• Paid wellness time and reimbursements.