Jobs at Oscar Health - Page 2

• Collaborate with cross-functional teams to identify healthcare data-related challenges and develop comprehensive solutions.
• Produce required data deliverables and provide technical & analytical support for Oscar’s Operations

• Facilitate instructor-led courses for claims audit teams
• Monitor quality metrics on an ongoing basis

• Work with important partners on a cohesive and comprehensive litigation strategy that aligns with our strategic goals
• Build our litigation strategy and ensure that a variety of complex litigation matters are managed

• Operating Plan Development:

Develop and track multi-year enterprise-wide Operating Plan, informed by enterprise Strategic Plan. Monitor progress against Operating Plan key metrics, own Operating Committee agendas, and drive follow ups to completion with critical stakeholders

• Develop and track multi-year enterprise-wide Operating Plan, informed by enterprise Strategic P...

• Lead the IA effort in performing risk assessments to identify technology risks at Oscar, and develop a risk-based IA plan for IT integrated internal audits
• In partnership with the Internal Audit team, develop and execute an internal audit plan for the Technology business.

• Organize and lead daily activities for claims issue resolution programs
• Identify, develop and implement program strategy, optimizations and tooling that support the organization’s objectives.

• Manage the financial performance for assigned market
• Develop and maintain key relationships with providers, regulators, and community partners

• Organize and support daily activities based on the goals of the claims issue resolution program
• Identify optimization opportunities to support program objectives

• Independently leads Oscar’s standardization process, inclusive of tool making, language development and proposals, rewrites, and drafting guides
• Participate in comprehensive legal reviews to document the rationale behind state specific differences and ensure submitted materials follow state and federal law

• Review and render decisions on authorizations and appeals for specialty, non-specialty, and physician administered drugs
• Conduct peer-to-peer calls with prescribers to discuss the clinical rationale of adverse determinations

• Shape the strategy of Workforce Management team around principles and guidelines
• Guide the success of planning, scheduling and real-time command center operations to achieve and maintain operational goals

• Hire and manage a team of Oscar colleagues with direct responsibility for performance management, their growth and development, and associated HR administrative tasks
• Manage your team’s outcomes, monitor dashboards, and track operational KPIs, conducting root-cause analysis and constructing action plans when issues arise

• Leads and cross collaborates on problem definition, acute error remediation, and root cause solution development
• Utilizes data to drive business decisions to impact cross-functional strategy

• Guide your team’s metrics, including member and provider satisfaction, quality of care (daily benchmark production) and employee satisfaction
• Coach direct reports through a culture of feedback and development to provide the best member/provider experience and care possible.

• Be the subject matter expert on assigned state and federal policy for provider dispute and IDR legislative matters, while applying newly proposed laws and regulations to processes in assigned jurisdictions.
• Support sustainable processes which simplify our growing team’s outputs while ensuring high qua...

• Management of all supplemental data feeds used for ACA Risk Adjustment submissions
• Outreach to new sources (ie. provider groups, vendors) to acquire supplemental data in a standardized format

• Hire and manage a team of Oscar colleagues with direct responsibility for performance management, their growth and development, and associated HR administrative tasks
• Manage your team’s outcomes, monitor dashboards, and track operational KPIs, conducting root-cause analysis and constructing action plans when issues arise

• Outreach providers and facilities to provide relevant, refined and impactful personalized options that address the members’ specific care requests while staying within service level agreement and meeting access standards.
• Lean on and collaborate with nurses for support on complex cases to route care

• Responsible for owning insights generation and follow-up for a major business unit, serving as the first point of contract for Sr. Managers and Associate Directors
• Analyze data to support business teams in making better informed, data-driven decisions

• Manages the corporate investment portfolio in accordance with corporate investment policy. Assists in developing strategy in partnership with Treasury leadership. Presents recommendations to corporate investment committee
• Manages relationships with third party asset managers including the selection of asset managers...