Manager, Medical Policy

Oscar Health(1 month ago)

RemoteFull TimeManager$131,200 - $172,200Office of Clinical Affairs (Clinical Policy)

About this role

The Manager, Medical Policy will lead clinical research and the development of evidence-based medical necessity criteria within the Office of Clinical Affairs, ensuring coverage decisions are supported by current literature and national standards. This role serves as the clinical subject matter expert for evidence appraisal, maintains the medical policy library, and presents findings to advisory and internal committees. The manager will also oversee and develop a team of clinical staff and ensure processes comply with regulatory and accreditation requirements.

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Required Skills

Clinical Research
Medical Policy
Literature Review
Evidence Synthesis
Technology Assessment
Clinical Review
Policy Drafting
Medical Writing
Team Leadership
Regulatory Compliance

+5 more

Qualifications

Graduate Degree in Healthcare-Related Field
Active Clinical License (RN/NP/PA)

About Oscar Health

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Oscar Health is a technology-driven health insurance company offering individual, family, and Medicare plans in select U.S. markets. It pairs insurance coverage with consumer-focused digital tools — a mobile app, telemedicine, and dedicated care teams — to simplify enrollment, care navigation, and claims management. Using data and provider partnerships, Oscar emphasizes preventive care, personalized support, and greater cost transparency for members.