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Hi, we're Oscar. We're hiring a Utilization Review Processor to join our Utilization Review team.
Oscar is the first health insurance company built around a full stack technology platform & a 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
You will solve complex issues or concerns impacting our providers & the members they serve. You will communicate with our Providers & work with teams across Oscar to provide efficient & thorough resolution by providing world class service. You will understand the importance of a world-class member experience when seeking care & actively identifies barriers to member care & member & provider satisfaction to solve for the future. You will manage their workload effectively by setting timely outreaches & actively communicating roadblocks to their team.
You will report to the Utilization Review Lead.
Work Location:
Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture & our mission.
If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.
You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote
Pay Transparency:
The base pay for this role is: $19.00 per hour. You are also eligible for employee benefits & monthly vacation accrual at a rate of 10 days per year.
Responsibilities
- Manage queue work & and assigned caseload through efficient dashboard management
- Identify, investigate, & resolve issues within determined SLAs
- Collaborate with colleagues, Specialists, Experts, & Leads to identify trends & roadblocks
- Use internal tools & resources seamlessly
- Communicate findings & resolutions with providers & internal departments
- Compliance with all applicable laws & regulations
- Other duties as assigned
Qualifications
- 1+ years of customer support/service experience
Bonus Points
- Advanced computer literacy skills with experience using CRM & knowledge management tools to resolve client issues
- Experience using ticket management & reporting tools
- Experience managing an assignment caseload
- Customer service experience
- Healthcare and/or SAAS experience
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
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.
Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, & experience. Full-time employees are eligible for benefits including: medical, dental, & vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life & disability insurance, & paid wellness time & reimbursements.
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.
California Residents: For information about our collection, use, & disclosure of applicants personal information as well as applicants rights over their personal information, please see our Notice to Job Applicants.
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