Program Lead, Payor Connections

Hi, we're Oscar. We're hiring a Program Lead, Payor Connections to join our Risk Adjustment team.

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

The Program Lead, Payor Connections works with internal and external Oscar partners and representing the needs and interests of the Risk Adjustment team to acquire digital and supplemental data for EDGE submissions. This new role will be an important owner of an important initiative. If you are comfortable overseeing an end-to-end process while operating with ambiguity and autonomy, this role is for you!

You will report to the Director of Risk Adjustment.

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.

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, 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, and Washington is: $98,400 - $129,150 per year. The base pay for this role in all other locations is: $88,560 - $116,235 per year You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities

• 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
• Implementing data feeds via SFTP or API
• Review and QA of supplemental data feeds; identify cause for failures
• Track feeds for trends or changes
• Collaborate across the organization to identify actions to achieve improvements and monitor initiative impact
• Develop relationships with provider group partners and vendors
• Help develop operational strategy and market approach
• Oversee the creation and maintenance of essential operational dashboards, and update and enhance them as our user’s needs evolve
• Compliance with all applicable laws and regulations
• Other duties as assigned

Qualifications

• 2+ years of work experience in operations, health insurance, data analysis, engineering or consulting
• 2+ years of experience providing projects / programs
• 2+ years of experience working with data file transfers (SFTP, API)
• 2+ years experience using SQL to manipulate and analyze large datasets to solve business problems

Bonus Points

• Risk Adjustment experience
• Experience using data to improve programs
• Experience / background in a fast-paced operations environment
• Healthcare experience (Health Insurance, Health Systems, or Healthcare Consulting)

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 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 ([email protected]) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Notice to Job Applicants.