Senior Manager, Insurance Product and Benefit Design

Oscar Health is a health insurance company focused on serving its members through a technology-driven platform. The Senior Manager, Insurance Product and Benefit Design will oversee the development of insurance plan designs, ensuring compliance and quality throughout the product lifecycle while optimizing workflows and processes.

Responsibilities:

• Manage end-to-end plan design across assigned geographies, including benefits, cost-sharing, and network considerations
• Translate market strategy, performance insights, and regulatory requirements into clear design decisions
• Lead the product lifecycle from design through filing, implementation, and post-launch performance
• Be the product owner for design within the regulatory filing process, ensuring accuracy across PBT's, SBC's and internal systems
• Promote agreement on actuarial, regulatory, compliance, network, and operational teams
• Establish and enforce disciplined operating rhythms across design and filing cycles, ensuring you meet timelines, dependencies, and deliverables
• Promote process optimization and standardization across markets to improve scalability, reduce defects, and enhance speed to market
• Lead continuous improvement efforts across product design and filing workflows, identifying inefficiencies and implementing sustainable solutions
• Partner to ensure seamless execution from design through regulatory filing submission, approval, and objection monitoring
• Evaluate program success against financial, operational, and provider/member experience goals
• Balance standardized plan design frameworks with targeted market-specific variations to maintain competitiveness
• Identify risks and lead resolution of complex design and execution issues
• Lead QA and go-to-market readiness reviews to ensure, compliant plan designs
• Interpret and conduct market, competitive, and regulatory analysis to inform strategy and positioning
• Mentor junior team members and support development of team capabilities
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• Bachelor's degree in business, healthcare, economics, finance, or related field
• 6+ years of experience in health insurance product and ACA / QHP benefit design with direct ownership over health plan design decisions
• Knowledge of ACA plan design, including cost-sharing structures, metal towers, EHB and regulatory requirements
• Experience leading regulatory filing processes, including PBT, SBC, and related documentation
• Operations experience following regimented processes associated with product development and regulatory filing processes, including ability to recommend process improvements for scale and optimization
• Experience operating in complex, matrixed organizations
• Willingness to travel up to 25% of the time
• Experience defining or managing standardized ACA plan design frameworks across multiple markets
• Familiarity with product configuration systems and downstream filing processes
• Experience with AV calculator strategies and benefit design trade-off analysis
• Exposure to portfolio management and lifecycle optimization
• Experience with SQL or advanced analytics tools
• Prior experience in ACA IFP plans