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Hi, we're Oscar. We're hiring a Claims Quality Senior Analyst to join our Claims Quality team.
Oscar is the first health insurance company built around a full stack technology platform & a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family.
About the role
The Claims Quality Senior Analyst is responsible for supporting process improvement & issue resolution in the Oscar claim environment. The Senior Analyst organizes, scopes, triages, investigates and/or executes on solutions & process improvements related to claims. This is accomplished by leveraging a deep understanding of Oscars end-to-end claim infrastructure, workflows, workflow tooling, platform logic, data models, etc.
You will report to the Manager, Claims Quality.
Work Location:
Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture & our mission.
If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.
You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote
Pay Transparency:
The base pay for this role in the states of California, Connecticut, New Jersey, New York, & Washington is: $72,800 - $95,550 per year. The base pay for this role in all other locations is: $65,520 - $85,995 per year. You are also eligible for employee benefits, participation in Oscars unlimited vacation program & annual performance bonuses.
Responsibilities
- Ingest information from internal & external partners regarding adverse claim outcomes; collaborate with partners to scope, size, prioritize items & deliver solutions.
- Utilize data analysis skills & tools to develop accurate, quantitative analyses of claims issues.
- Translate observations, findings & analysis results into business requirements; submit to & collaborate with internal partners to effectuate change.
- Use insights from partner submissions, data mining, process monitoring, etc., work with the team to proactively identify thematic areas of opportunity to solve problems.
- Perpetuate a culture of transparency & collaboration by keeping stakeholders well informed of progress, status changes, blockers, completion, etc.; field questions as appropriate.
- Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc. whenever issues are escalated & assigned by leadership.
- Compliance with all applicable laws & regulations
- Other duties as assigned
Qualifications
- 3+ years of experience in claims processing or auditing within healthcare operations
- 2+ years experience improving business workflows & processes
- 1+ years experience collaborating with internal and/or external stakeholders
Bonus Points
- A bachelors degree or 4+ years of commensurate experience
- An academic and/or professional background in engineering, data, or healthcare
- Experience in a professional healthcare claims organization
- Knowledge management, training, or content development in operational settings
- Process Improvement or Lean Six Sigma training ands
- Experience using SQL
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
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.
Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, & experience. Full-time employees are eligible for benefits including: medical, dental, & vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life & disability insurance, & paid wellness time & reimbursements.
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.
California Residents: For information about our collection, use, & disclosure of applicants personal information as well as applicants rights over their personal information, please see our Notice to Job Applicants.
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