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Oscar Health // health insurance
 
New York City    Posted: Tuesday, December 22, 2020
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. Were hiring a Quality Improvement Operations Associate to join our Quality Operations team in our New York office. 

Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 & headquartered in New York City. Our goal is to make health insurance simple, transparent, & human. We need your help to do so.

About the role:

This role will work on NCQA accreditation & delegated quality activities on behalf of Oscars national corporation. This person will act as a subject matter expert in NCQA Utilization Management, Credentialing & Network Management Standards. You will report into the 

Manager, Quality Improvement

Responsibilities:

  • Responsible for project management of corporate NCQA activities for UM, CR, & any additional national accreditations. 
  • Act as a subject matter expertise & provide education on NCQA standards related to UM, CR, & PN.
  • Ensure consistency of accreditation standards interpretation & process implementation.
  • Review & approve documents, including policies, to ensure they meet NCQA requirements.
  • Upload completed documents to the NCQA IRT tool.
  • Ensure the IRT tool accurately reflects submission of standards & documents.
  • Manage Mulberry Management Corporation (MMC) documentation needs related to its sister organization relationships & the Cigna partnership.
  • Coordinate & oversee reporting, adherence needs, & quality improvement activities that support our strategic partnerships.
  • Ensure that other standards are followed in these areas as needed by partnership agreements.
  • Maintain knowledge of industry trends & practices.

Requirements:

  • 3+ years of healthcare related experience in project management, quality improvement/management, managed care or population health. 
  • 2+ years of experience spent directly working on NCQA UM/CR Accreditation.
  • Associates degree or equivalent work experience required
  • You have worked with quality improvement methodologies, research, & data analysis
  • You have experience interacting with internal & external stakeholders. 
  • You are a collaborator & can follow a project plan while driving cross-functional teams to execute against considering competing priorities & viewpoints.

Bonus points:

  • Knowledge of industry best practices & regulatory compliant reporting.
  • Management experience with URAC standards.
  • Familiarity with other NCQA accreditation programs (ie. Provider Network, Multicultural Health Care, Population Health Program, Case Management, MBHO, etc.)

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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