Events  Deals  Jobs 
    Sign in  
 
 
Oscar Health // health insurance
 
Tempe, Arizona, United States    Posted: Friday, September 03, 2021
 
   
 
Apply To Job
 
 
JOB DETAILS
 

Hi, we're Oscar. Were hiring a Clinical Review Expert  to join our Clinical Review team in our Tempe  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:

Clinical Review Team (CRT) Experts are leaders in the CRT possessing area & have a passion for teaching others with aspirations to improve CRT workflows.  A role model in all KPIs, CRT Experts act as an ambassador for feedback & consistently identify solutions when areas of opportunity exist. They are approachable, empathetic, & profoundly positive yet realistic. Their mastery of the CRT Processor role creates trust, admiration, & respect, ensuring they are seen as a go-to resource for their peers.  CRT Experts work in tandem with their Team & Operations Leads, mentoring CRT Processors & promoting CRT success.  Lastly, they act as a support mechanism for CRT Processors when a Team Lead is out-of-office, providing them with unique experiences that will grow leadership competencies.

You will report to the Clinical Review Team Lead.

Responsibilities:

  • Provides appropriate solution to cases
  • Supports escalations when business needs arise
  • Provides feedback to Team Lead(s)  as it relates to process & workflows to assist leadership to create efficiencies & increase productivity by eliminating waste
  • Becomes a subject-matter expert within an assigned line of business (IFP, MA, etc.)
  • Becomes a trainer within  an assigned line of business (IFP, MA, etc.)
  • Oversight to production dashboards to ensure cases meet turn-around-times (TAT) & escalate according to policy
  • Identify gaps in content/knowledge, collaborating with training to create content for CRT and/or delivering training

Requirements:

  • Two (2) years of healthcare/health insurance experience, or a bachelor's degree.

Bonus points:

  • Knowledge of authorization processing & medical terminology
  • In depth knowledge of Utilization Management authorization processing
  • Experience handling Personal Health Information (PHI) in a professional manner
  • Experience entering accurate data in a production-driven environment

Life at Oscar: 

Our more than 1,000 employees aim to make health care affordable & accessible for all. We apply this same vision to our perks & benefits, including: medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, & volunteer opportunities.

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 your unique background & perspectives.

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.

COVID-19 vaccine requirements for in-person work: 

To protect the health & safety of our employees, we require any employee conducting in-person work* to be fully vaccinated against COVID-19 by their start date. 

If you are unable to be vaccinated due to medical or protected religious reasons, please reach out to our Benefits team at accommodations@hioscar.com to submit an accommodations request.

*Note: In-person work includes: employees required to work from our offices (either full-time or part-time), employees conducting sales work in the field & employees conducting at-home or in-person visits with members.

 
 
 
Apply To Job
 
 
 
 
 
© 2021 GarysGuide      About    Feedback    Press    Terms