Manager, Insurance Product and Benefit Design

About the Role

The Manager, Insurance Product & Benefit Design is entrusted with architecting and refining health plan structures that translate strategic vision into precise configurations. You own the design integrity across systems and documents, ensuring every element adheres to regulatory standards and market expectations. This role demands clear judgment and steady coordination to move concepts from initial ideation to compliant execution. You will directly own the configuration logic that dictates how benefits and cost sharing behave in the marketplace. It requires synthesizing complex regulatory requirements into actionable design rules that are both compliant and member-centric. You report directly to the Vice President, Insurance Product Innovation and Development, acting as a critical bridge between strategy and implementation. This position is fundamental to translating Oscar's tech-enabled vision into tangible, market-ready insurance products.

Key facts

What you'll do

Chart intake requirements and convert them into executable design rules that govern benefits and cost sharing structures.

Design benefit structures and cost-sharing models while coordinating closely with partners to ensure alignment on execution and feasibility.

Conduct design validations to confirm that filings, system mappings, and member materials remain consistent, accurate, and compliant.

Draft configuration specifications and review them in detail alongside regulatory and compliance teams to secure formal sign off.

Guide products through distinct phases including design, filing, implementation, and launch readiness checkpoints to ensure smooth progression.

Drive process standards and operating rhythms to maintain momentum, manage timelines, dependencies, and keep deliverables on track.

Scan market trends and regulatory shifts to recommend design adjustments that enhance competitiveness, scalability, and long-term viability.

Steer continuous improvement across workflows by identifying bottlenecks, testing sustainable solutions, and refining operational efficiency.

Verify plan designs, regulatory filings, and system setups through rigorous quality checks before any public release or member exposure.

Monitor launched plans to detect performance gaps, analyze outcomes, and surface improvement opportunities for application in future benefit cycles.

Requirements

You hold a Bachelor's degree in business, healthcare, economics, finance, or a related field that provides a foundational understanding of complex systems.

You bring 5 or more years of cumulative experience in health insurance product, ACA benefit design, regulatory filings, or closely related work that demands precision.

You thrive operating within regimented product development and regulatory filing processes while proactively suggesting optimizations that improve clarity and efficiency.

You understand the ACA and small group design landscape deeply, including cost-sharing structures, metal tiers, and essential health benefits that define member coverage.

You have direct experience with regulatory filings or artifacts such as PBTs, SOBs, and SBCs, ensuring accuracy and compliance in all deliverables.

You pay meticulous attention to detail while managing complex benefit configurations across multiple systems and extensive documentation sets.

You have a proven track record of working cross functionally with actuarial, finance, regulatory, network, and operations teams to achieve shared objectives.

You analyze quantitative and qualitative data to support decisions and synthesize findings into clear narratives that influence plan strategies.

Nice to have

Experience working in matrixed environments and coordinating effectively with network and vendor partners to navigate complex dependencies.

Practical notes

This role is remote but requires residence in one of the following states: Arizona, California, Colorado, Florida, Georgia, Illinois, Massachusetts, Michigan, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Texas, or Virginia. Note that this list of states is subject to change based on regulatory and business considerations. Please ensure you are able to perform the work posted for You must follow all scope, guidelines, and procedures outlined in the job description without deviation.