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Oscar Health // health insurance
 
New York City    Posted: Friday, January 08, 2021
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. Were hiring an Operations Associate to join our Medicare Advantage 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 plays an essential role in operating our Medicare Advantage (MA) business. Responsible for providing subject matter expertise to service & operations teams, promote infusion of MA knowledge into operations teams supporting the product line, develop & maintain training & resource materials for operations teams & identifying opportunities to support the ongoing effort to achieve operational excellence in our MA operations 

You will report into the Sr. Director, Medicare Advantage.

Responsibilities:

  • Support efforts to achieve operational excellence in our Medicare Advantage product.
  • Partnering with the Learning & Development team support the development, maintenance, & delivery of MA training programs & materials for operations teams, including (but not limited to): Customer Service, Provider Service, Enrollment, & Claims
  • Be responsible for maintenance of the repository of resource materials used by the MA Customer Service team on a day-to-day basis, including routine review of existing content & development of new or revised content to facilitate optimal call handling & resolution.
  • Serve as an MA subject matter expert & day-to-day escalation point for service teams & operations units.
  • Perform routine monitoring of Customer Service & Provider Service calls to identify opportunities for improvement. Coordinate the process improvement initiatives needed to address those opportunities.
  • Perform routine monitoring of MA-related processes, including enrollment file handling & claims processing. Identify opportunities to improve adherence to regulatory requirements & optimize efficiencies. Drive corrective actions needed to address those opportunities.
  • Partner with MA operations teams to execute on Star Ratings-related initiatives.
  • Support program to identify & mitigate root causes leading to CTMs & grievances.

Requirements:

  • Bachelors Degree or 6 years working for an MA plan in an operations or compliance role 
  • 3+ years of work experience in a Medicare Advantage (MA) plan working in an operations or compliance role

Bonus points:

  • Ability to identify problems & initiate corrective actions & preventive actions utilizing various quality tools.
  • Self-motivated, & focused on continuous improvement with the ability to work independently and/or on a team with minimal supervision

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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