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Oscar Health // health insurance
 
New York City, United States    Posted: Wednesday, July 08, 2020
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. Were hiring a Director to lead our Payment Integrity 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 team is responsible for ensuring the integrity of Oscars claim payments. We think we can make healthcare more affordable by being relentless in our pursuit of payment accuracy & building systematic solutions for reducing the amount of fraud, waste, & abuse across the industry.

In this role, your mandate will include setting & executing an innovative vision for building a best-in-class, scalable claims cost management program that leverages technology, deep subject matter expertise, & lean operations. You will partner with a broad set of leaders across the organization in order to achieve this mission & deliver results.

This role reports to Oscars Senior Director of Clinical Operations.

Responsibilities:

  • Set & meet ambitious quarterly & annual targets
  • Steer the design of measurable, repeatable, & scalable tools & processes to manage our costs, always identifying opportunities for efficiency & automation
  • Stay abreast of industry developments, new capabilities, & technological/regulatory developments in order to generate new ideas & implement ROI-positive initiatives
  • Foster widespread engagement with Oscars payment integrity program, whether its informing hospital contract negotiations or developing more robust payment policies
  • Ensure that our program is compliant with applicable regulations, policies, & procedures
  • Support & chart growth paths for your team members
  • Drive the culture at Oscar through your daily actions & leadership

Requirements:

  • 7+ years of work experience in health insurance, payment integrity, clinical operations, and/or fraud, waste, & abuse
  • Experience leading & inspiring teams
  • An affinity for managing internal teams, external vendors, & cross-functional initiatives
  • A desire to eliminate waste while driving operational excellence
  • Ability to communicate with a wide variety of audiences across all levels of the organization
  • Familiarity with claim payment methodologies, billing software/analytics, & revenue lifecycle

Bonus points:

  • Experience at a start-up or high-growth company
  • Familiarity with medical terminology, DRG/APC payment methodologies, professional & facility coding, and/or billing analytics platforms

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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