Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

This role is responsible for designing, optimizing and implementing processes and improvements for configuring Oscar's claims adjudication platform. This role works cross-functionally to identify, scope, build, test and implement solutions, with a focus on creating efficiency and scale through technology and automation.

You will report to the Operations Manager, Edits Configuration.

Work Location:

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.

This is a hybrid role in our New York City office. You will work part of the time in the office and part of the time remote / work-from-home. #LI-Hybrid

Pay Transparency:

The base pay for this role is: $98,400 - $129,150 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities

Leads and cross collaborates on iterative problem definition and technical design and scoping to build solutions with the end-user in mind
Work cross functionally to gather and translate business requirements such as clinical and medical policies into technical requirements for implementation
Utilizes data to independently drive business decisions, impact cross-functional strategy and develop KPIs to measure the effectiveness of payment integrity initiatives
Proactively identify risks; responds to and resolves issues/errors/escalations through data-driven investigation to produce insights for short, medium, and long-term technology-enabled solutions
Distills the requirements of new product and market expansions and designs automated workflows to reduce manual work requirements within claims operations
Works with other team members to resolve issues, develop training, and create technical tooling to enable others
Compliance with all applicable laws and regulations
Other duties as assigned

Qualifications

A bachelor's degree or 4+ years commensurate experience
3+ years experience in operations, health insurance, data analysis, engineering and/or consulting
3+ years experience using data software such as Excel, SQL or Python
3+ years experience in analytics & ability to derive insights from complex, broad datasets
1+ years experience designing and improving workflows as well as standing up accompanying operating and technical procedures

Bonus points

Process Improvement or Lean Six Sigma training
Experience with healthcare payment policies
Experience using SQL

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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 and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives..

Pay Transparency:

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.

Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

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.

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