Senior Manager, Insurance Product and Benefit Design
Job description
About the role
Owning Oscar health plan strategy requires mastery from initial intake through final execution and partnership. You will manage insurance design across selected markets, transforming strategic direction into compliant structures while balancing scalable patterns with regional distinction. You will guide the full product lifecycle from conception through regulatory filing, implementation, and ongoing performance monitoring, ensuring consistent quality and optimization. You will serve as the design product owner within regulatory workflows, ensuring precise and accurate PBT and SBC documentation alongside cross-functional allies. You will establish and maintain rigorous operating rhythms for design and filing cycles, coordinating timelines, dependencies, and deliverables to ensure predictable market progress. You will interpret competitive, market, and regulatory intelligence to shape positioning and collaborate closely with teammates to elevate the entire group's capability. You will evaluate plan frameworks against financial, operational, and member experience objectives, resolving intricate design risks through thorough quality assurance. The role demands meticulous ownership, proactive problem solving, and disciplined collaboration to advance Oscar's market position and member value.
Key facts
What you'll do
- Analyze complex market requirements and translate them into structured health plan designs that align with Oscar's strategic priorities.
- Architect insurance plan frameworks, defining coverage structures, benefit configurations, and cost-sharing models to meet diverse member needs.
- Synthesize regulatory guidance and compliance standards, ensuring all plan components adhere to ACA, state, and federal requirements.
- Coordinate cross-functional stakeholders to shepherd product concepts from ideation through validated implementation plans.
- Draft and finalize Plan Benefit Tracker (PBT) and Summary of Benefits and Coverage (SBC) documents with precision and regulatory accuracy.
- Construct detailed operational workflows that map design decisions to filing schedules, review checkpoints, and execution milestones.
- Monitor competitor positioning and market dynamics to identify opportunities for differentiation and improvement in plan offerings.
- Partner with legal, compliance, and finance teams to validate assumptions and secure alignment on product strategies.
- Conduct scenario testing and design validation to uncover gaps, mitigate risks, and refine plan architecture before launch.
- Lead quality assurance reviews, confirming that all plan materials meet Oscar's standards for clarity, completeness, and consistency.
- Drive continuous improvement initiatives that streamline design processes, enhance scalability, and reduce time to market.
- Mentor emerging team members, sharing expertise in ACA plan structures and regulatory best practices to strengthen group capability.
- Track and report on plan performance indicators, using insights to recommend adjustments and optimize future designs.
- Serve as the primary point of contact for regulatory inquiries, ensuring timely and accurate responses to oversight bodies.
Requirements
The candidate for must meet the following eligibility criteria and hard bars as stated in the source listing. You must possess a bachelor's degree in business, healthcare, economics, finance, or similar fields. You must hold a minimum of six years directing health plan decisions and owning insurance product strategy. You are required to have deep expertise in ACA plan architecture, including cost-sharing models, metal tier structures, essential health benefits, and all relevant regulatory requirements. You must demonstrate hands-on experience shepherding PBT, SBC, and associated documentation through complex regulatory submissions with precision and clarity. A bachelor's degree in business, healthcare, economics, finance, or related fields is mandatory for this role. You must bring six plus years of experience in health insurance product and ACA/QHP benefit design with direct ownership of health plan decisions. You are expected to have comprehensive knowledge of ACA plan design, cost-sharing structures, metal towers, EHB standards, and regulatory requirements. You must have a proven track record of leading regulatory filing processes, including PBT, SBC, and related documentation. You are required to have operations experience following regimented processes tied to product development and regulatory filing. You must be able to recommend process improvements for efficiency and scale. You are expected to comply with all applicable laws and regulations in the execution of this role. You must be prepared to adhere to other duties as assigned and support the broader objectives of the Oscar Health team.
Nice to have
The source listing does not specify any preferred or nice-to-have qualifications beyond the stated requirements.
About the company
Oscar helps people and employers choose health insurance plans that fit their everyday needs. You compare options, find providers, and manage care through a simple digital interface. Members handle appointments, claims, and questions with guidance when needed. Teams work across product, design, and operations to support smoother experiences for members and partners. Practical notes