Oscar Health Logo

Oscar Health

Senior Manager, Actuarial - Risk Adjustment

Posted 15 Days Ago
Be an Early Applicant
Remote
Hiring Remotely in USA
148K-215K Annually
Senior level
Remote
Hiring Remotely in USA
148K-215K Annually
Senior level
Leads actuarial risk adjustment work for ACA health insurance, including risk score and morbidity forecasting, financial close support, reporting and forecast model development, transfer estimates, performance analysis, audits, internal controls, automation, documentation, stakeholder collaboration, and analyst onboarding.
The summary above was generated by AI

Hi, we're Oscar. We're hiring a Senior Manager, Actuarial - Risk Adjustment to join our Actuarial team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Actuarial Sr. Manager will be a key player in helping Oscar to understand the financial implications to the ACA's risk adjustment program. You will support multiple aspects of the actuarial team's risk adjustment work, including supporting monthly financial close, ongoing forecasting, and various other analyses. This is a very dynamic space, which makes this a great opportunity to work on interesting projects and have a BIG impact.

You will report into the VP, Actuarial.

Work Location: This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $163,944 - $215,177 per year. The base pay for this role in all other locations is: $147,550 - $193,659 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

  • Live on the cutting edge by developing Oscar's ability to predict Oscar's risk scores and ACA market morbidity, working with a cross functional team of actuaries and data scientists.
  • Showcase resourcefulness and creative thinking in sourcing new data for making Oscar and market level predictions in innovative ways.
  • Maintain and evolve core risk adjustment reporting and forecast models.
  • Conduct research and enhance Oscar's risk adjustment knowledge and capabilities, including views of both Oscar's membership and other carriers in the market.
  • Key contributor in estimated risk adjustment transfer estimates for monthly closes and ongoing financial forecasts.
  • Conduct various risk adjustment related analyses, including analyzing drivers of risk adjustment performance.
  • Lead quarterly audit deliverables and maintain internal control compliance to support accurate financial reporting.
  • Promote and shape Oscar actuarial best practices with respect to automation and documentation.
  • Maintain strong relationships, rapport, and lines of communication with both internal and external stakeholders.
  • Aid in the onboarding of analysts by collaborating and integrating them into existing processes.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • College degree or commensurate skills attainment.
  • Associate or Fellow of the Society of Actuaries (SOA).
  • 6+ years of quantitative analysis experience.

Bonus points:

  • Strongly prefer ACA Risk Adjustment, ACA Pricing/MedEcon, or Non-ACA Risk Adjustment expertise.
  • Strong understanding of health insurance concepts and nuances.

This is an authentic Oscar Health job opportunity.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency:  Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([email protected]) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy.

HQ

Oscar Health New York, New York, USA Office

New York, NY, United States, 10013

Similar Jobs

22 Minutes Ago
Remote or Hybrid
75K-140K Annually
Mid level
75K-140K Annually
Mid level
Artificial Intelligence • Fintech • Insurance • Marketing Tech • Software • Analytics
Investigates, evaluates, and resolves complex environmental, auto, and general liability claims. Reviews coverage, liability, damages, reserves, subrogation, and suspicious claims; coordinates with counsel and consultants; manages litigation, mediations, settlements, and trials; communicates with policyholders; and recommends case strategies and values. Also maintains action plans and supports training for less experienced staff.
3 Hours Ago
Remote or Hybrid
100K-100K Annually
Mid level
100K-100K Annually
Mid level
eCommerce • Legal Tech • Professional Services • Software • Data Privacy
The Senior Referral Affiliate Manager manages affiliate profiles, develops relationships, strategizes growth, conducts competitive analysis, and negotiates deals in a service-based affiliate role.
Top Skills: Shareasale
3 Hours Ago
Remote or Hybrid
65K-65K Annually
Junior
65K-65K Annually
Junior
eCommerce • Legal Tech • Professional Services • Software • Data Privacy
As an Ad Buyer, you'll conduct market research, set up and manage ad campaigns, and monitor their performance while collaborating with the marketing team.
Top Skills: Facebook Ads ManagerGoogle Ads

What you need to know about the NYC Tech Scene

As the undisputed financial capital of the world, New York City is an epicenter of startup funding activity. The city has a thriving fintech scene and is a major player in verticals ranging from AI to biotech, cybersecurity and digital media. It also has universities like NYU, Columbia and Cornell Tech attracting students and researchers from across the globe, providing the ecosystem with a constant influx of world-class talent. And its East Coast location and three international airports make it a perfect spot for European companies establishing a foothold in the United States.

Key Facts About NYC Tech

  • Number of Tech Workers: 549,200; 6% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Capgemini, Bloomberg, IBM, Spotify
  • Key Industries: Artificial intelligence, Fintech
  • Funding Landscape: $25.5 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Greycroft, Thrive Capital, Union Square Ventures, FirstMark Capital, Tiger Global Management, Tribeca Venture Partners, Insight Partners, Two Sigma Ventures
  • Research Centers and Universities: Columbia University, New York University, Fordham University, CUNY, AI Now Institute, Flatiron Institute, C.N. Yang Institute for Theoretical Physics, NASA Space Radiation Laboratory

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account