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Oscar Health // health insurance
 
Remote    Posted: Wednesday, August 11, 2021
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. Were hiring a Sr. Operations Analyst to join our SIU Team. 

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

About the role:

In this role, you will get to build needed dashboards for the SIU & Prepay Teams.  Review dashboards for aberrancies, research any identified anomalies & report to appropriate parties. Perform validation audits of information feeding the dashboards to ensure accuracy.  Perform research on signals developed by data to determine viability & ROI.  Update all reporting documents for leadership.

The team is new & growing, as a result the data needs to be set up in a visually appealing & accurate manner.  This information has high level visibility & impacts a top vital for the organization.  This role will help ensure that the SIU is able to quickly respond to changes in trends, aberrant issues, & keep leadership up to date on progress while helping increase the ROI on claims identified for high risk review.

You will report into the Director, SIU. This is a remote role, you will work remotely in one of the following states: Arizona, California, Connecticut, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Utah, Virginia, or Washington. Note, this list of states is subject to change.

Responsibilities:

Develop & maintain the dashboards & reporting that reflect the work of the SIU. Partner with cross-functional teams to improve signals feeding work to the investigators & prepay.

Requirements:

  • Bachelor's degree or 2+ years of related work experience in analytics 
  • 2+ years of professional experience
  • Experience using Microsoft Office applications & data visualization tools (e.g. Periscope & Tableau)

Bonus points:

  • Certification applicable to this work such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] & Fraud Professional (CAFP), other coding certifications or similar
  • Knowledge of applicable fraud statutes & regulations, & of federal guidelines on recoupments & other anti-FWA activity
  • Experience working in health insurance specifically with claims processing, billing, reimbursement, provider contracting, or enrollment.
  • Exposure to payment integrity & payment policy optimization
  • Exposure to SQL, Python, or similar database languages
  • Experience with HIPAA, data privacy, and/or data security processes

Life at Oscar: 

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 & find both belonging & support. We're on a mission to change health care -- an experience made whole by our unique backgrounds & perspectives.

We encourage our members to care for their whole selves, & we encourage our employees to do the same with comprehensive medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, & volunteer opportunities.

Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicants disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

Pay Transparency Policy:

Oscar ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.

 
 
 
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