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Oscar Health // health insurance
 
New York City, United States    Posted: Thursday, June 10, 2021
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. We're hiring an Operations Associate to join our Payment Integrity, Insurance Operations team in our New York City 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:

The Payment Integrity team at Oscar focuses on Oscar's company-wide goal to make healthcare more affordable & efficient by designing scalable processes & building data-driven solutions powered by technology. Our work favorably impacts Oscar's price position through reducing claims payment leakage & surfacing & addressing fraudulent, wasteful, & abusive practices. The Payment Integrity team drives several operational programs, including payment policies & guidelines, high risk claims reviews, claims audit & edit processes.

As an Operations Associate at Oscar, you will guide projects to build a operational foundation across the organization. You will help determine processes, identify areas for potential improvement, & allow support where needed. You will manage third-party system implementations to expedite our growth. You will have an impact in making healthcare more affordable by preventing & reducing fraudulent, wasteful, & abusive (FWA) behavior in the industry. Note that you will have tremendous growth & leadership opportunities as we continue to grow. We are looking for people who are excited to grow with us.

You will report to the Manager, Insurance Operations.

Responsibilities:

  • Define our FWA strategy by shaping the development of value cases, standard operating procedures, & playbooks
  • Identify & recommend opportunities for process improvements (including tools & systems) to help us reach our efficiency targets
  • Manage system implementations to ensure milestones are delivered on time & risks are escalated to appropriate parties
  • Become well-acquainted with internal tools & technical processes, & develop insights into improvement opportunities
  • Become an in-house expert on all claims-related matters required to properly resolve payment integrity cases & provide escalation support to the claims processing team
  • Analyze performance, identify issues & areas of opportunity for process improvements, & work on those projects
  • Take ownership of monitoring, tracking, & statusing the health of our inventory (including development of dashboards & defect monitoring/maintenance)
  • Support your team lead or manager by guiding decisions & implementation on an ongoing basis

Requirements:

  • Bachelor's degree or 3+ years of related work experience in healthcare, analytics, or operations
  • Exceptional analytical & quantitative problem-solving skills
  • Ability to communicate complex ideas effectively, both verbally & in writing
  • Experience managing projects to completion
  • Proficiency in SQL
  • Experience with system implementations

Bonus points:

  • Exposure to payment integrity & reimbursement policy optimization
  • Exposure to Python, or similar database languages
  • Experience in Management Consulting/Investment Banking

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 applicant's 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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