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Operations Manager
Claims Design & Configuration
Posted on 11/23/2022
INACTIVE
Locations
Remote
Experience Level
Entry
Junior
Mid
Senior
Expert
Desired Skills
Data Analysis
Data Science
SQL
Excel/Numbers/Sheets
Requirements
  • A bachelor's degree or commensurate 4+ years of operating experience
  • 2+ years experience with medical billing, payment integrity, medical coding
  • Experience with SQL (ability to at least write basic SQL queries)
  • 5+ years experience in operations, health insurance, data analysis, engineering or consulting
  • 5+ years of experience manipulating and analyzing large datasets using excel (can write advanced macros) or a similar database language to solve business problems
  • Experience developing project plans coordinating with all partners
  • Experience designing and improving workflows and standing up accompanying operating and technical procedures
Responsibilities
  • Become the subject matter expert for edits configuration within Claims operations - develop an understanding of the regulatory landscape and Oscar's operational ecosystem
  • Develop foundational processes for our scaling operations and summarize the complexity of our data and operations into clear explanations
  • Run and bring technical and operational improvements to Oscar's claims processes to ensure compliance, improve scalability, and manage risks
  • Collaborate with our teams and external vendors and partners to achieve expansion and platform targets and important operational metrics
  • Surface data, process, and technology issues through proactive identification, measurement, and monitoring of our operations
  • Partner within Operations and with Product & Engineering or Data Science teams to deliver the next generation of health insurance operations
  • Support your team and leadership by guiding decisions and implementation on an ongoingbasis
Desired Qualifications
  • Certified Professional Coder (CPC) certification
  • Process Improvement or Lean Six Sigma training
  • Experience with healthcare claims processing
Oscar Health

1,001-5,000 employees

Health insurance company
Company Overview
Oscar Health’s mission is to make high-quality health insurance accessible and affordable for everyone. The company is a software driven health insurance company that offers medical plans, medicare advantages, and small group products.
Benefits
  • Health insurance - That’s a given. Employees and their families receive incredible health insurance.
  • Financial benefits - A penny saved....we’re talking about a 401K plan, health savings accounts, and more.
  • Well @ Oscar - We care about your wellness with fitness classes and access to mental health support.
  • Work-Life Balance - We offer multiple time-off options, wellness days, and 10+ weeks of parental leave.
  • Learning & Development - We offer everything from mentorship to management training.
Company Core Values
  • What we do is a big deal. We’re solving problems that change and save lives.
  • Powered by people. Members above all. Developing and growing others is what raises the bar.
  • No genius without grit. Be relentless. Be scrappy. Trying and failing beats not trying and changing nothing.
  • Seek the truth... but never assume you’ve found it. Be scientific.
  • Inspire & provoke. Develop and display leadership at all levels. Fight to be the best.
  • Be transparent. Give and ask for direct feedback. Be grateful for and excited by the help of others.
  • Make it right. Admit your mistakes. Then learn from them. Never build alone.