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Oscar Health focused on utilizing tech, data & design to transform healthcare.
Engineering, Full Time    New York City    Posted: Wednesday, January 09, 2019
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What is the Position?

In this role, you will work within Oscars Operations organization to build & improve upon Oscars adjudication infrastructure & underlying logic, playing a key role in the transition to a next generation technology platform for core insurance functions. You will be responsible for designing & implementing the rules that determine when & how to pay claims, for establishing integrations to enable Oscars entry into Medicare Advantage, & will work closely alongside Oscars Tech, Risk, & Network teams to connect your work into the broader Oscar ecosystem. Finally, you will be the owner of initiatives that will contribute to a unique provider & member experience & will be vital to supporting Oscars growing membership.

Youll work alongside the rest of the Insurance Operations team, Claims & Member Engineering, data scientists, & business leads to get your work done. Well expect you to understand complexity, distill it, & explain it in simple, structured terms.

Deliverables: What you have to achieve

During the first 6 weeks you have:

  • Developed a thorough understanding of the operations ecosystem (including the underlying technology) as well as its current strengths, weaknesses, & gaps.
  • Internalized the coding languages & data structures used in both older health industry systems & the next generation tech platform that Oscar is building.
  • Begun to form a strong working relationship with internal & external stakeholders.

During the first 6 months you have:

  • Independently built scripts & tools to ensure seamless data integrations between Oscars external partners & its new insurance technology stack.
  • Become an expert on the rules & requirements of Medicare Advantage & its differences from Oscars current product offerings.
  • Partnered closely with the Claims Engineering org to structure & operationalize the next generation of Claim & Member data.

On an ongoing basis you will:

  • Build & oversee Claims & Member data integrations & accompanying technical projects for Oscars entrance into Medicare Advantage.
  • Distill the requirements of new product & market expansions & design automated workflows to reduce manual work requirements.
  • Support the Claims & Member configuration operations team to resolve provider & member escalations through issue investigation, training, & technical tooling.

What leads to success in this role?

Must-have qualities include:

  • A bachelors degree
  • A technical bend & the ability to use tools to answer your own questions (e.g. SQL/Python)
  • Outstanding structured, systematic, & critical thinking
  • A passion for distilling complex concepts & workflows into clear, concise content
  • A demonstration of deep analytical skills
  • A strong desire to follow through ideas until you implement them in reality
  • 2-4 years experience in a technical role (QA analyst, PM, operations analyst, finance, consulting, industrial engineering)

We think it will make a big (positive) difference if you have...

  • An academic & professional background in coding, math, statistics, or data science
  • Knowledge & passion of healthcare and/or health insurance
  • Insatiable curiosity of subject matter & a desire to seek the truth
  • Knowledge management, training, or content development experience
  • A willingness to master the detail but also zoom out to understand the big picture
  • Start-up experience
  • An enjoyment experimenting & iterating on ways to solve a problem

We are an equal opportunity employer & value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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