Hi, we’re Oscar. We’re hiring a Utilization Review Processor to join our Utilization Review 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

You will solve complex issues or concerns impacting our providers and the members they serve. You will communicate with our Providers and work with teams across Oscar to provide efficient and thorough resolution by providing world class service. You will understand the importance of a world-class member experience when seeking care and actively identifies barriers to member care and member and provider satisfaction to solve for the future. You will manage their workload effectively by setting timely outreaches and actively communicating roadblocks to their team.

You will report to the Utilization Review Lead.

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, Indiana, 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 is: $19.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 10 days per year.

Responsibilities

• Manage queue work and and assigned caseload through efficient dashboard management
• Identify, investigate, and resolve issues within determined SLAs
• Collaborate with colleagues, Specialists, Experts, and Leads to identify trends and roadblocks
• Use internal tools and resources seamlessly
• Communicate findings and resolutions with providers and internal departments
• Compliance with all applicable laws and regulations
• Other duties as assigned

Qualifications

• 1+ years of customer support/service experience

Bonus Points

• Advanced computer literacy skills with experience using CRM and knowledge management tools to resolve client issues
• Experience using ticket management and reporting tools
• Experience managing an assignment caseload
• Customer service experience
• Healthcare and/or SAAS experience