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Senior Manager, Claims Platform Configuration

Oscar Health

Oscar Health

Remote
Posted on Tuesday, June 25, 2024

Hi, we're Oscar. We're hiring a Senior Manager to join our Claims Platform Configuration 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 Senior Manager, Claims Platform Configuration is responsible for designing, optimizing and implementing processes and improvements for Oscar’s claims platform related to provider data and pricing. This role will often deal with navigating ambiguous situations and recommend solutions based on subject matter expertise often through influencing upper management. The Senior Manager, Claims Platform Configuration leads a team 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 Associate Director, 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.

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, 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: $144,000 - $189,000 per year. The base pay for this role in all other locations is: $129,600 - $170,100 per year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program and annual performance bonuses.

Responsibilities

  • Support team and leadership by driving decisions, owning team strategy including quarterly goal setting, and ensuring accountability for deliverables on an ongoing basis.
  • Partner with more senior leaders on forward-thinking goals and roadmaps, and provide clarity and direction to highly ambiguous problems in areas such as claims pricing, network status determination, and provider data reconciliation
  • Proactively coalesces cross functional business requirements in order to implement and improve the efficacy and efficiency of existing operational processes or to unlock new platform capabilities.
  • Utilizes data to independently drive business decisions, impact cross-functional strategy and develop KPIs to measure the effectiveness of pricing configuration.
  • Proactively identify risks; respond to and resolve issues/errors/escalations through data-driven investigation to produce insights for short, medium, and long-term technology-enabled solutions.
  • 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

  • Bachelor’s degree, or 4 years of commensurate experience.
  • 6+ years experience in operations, health insurance, data analysis, engineering and/or consulting.
  • 6+ years of experience using data software such as Excel, SQL or Python.
  • 6+ years experience developing project plans coordinating with internal and external stakeholders.
  • 6+ years experience designing and improving workflows as well as establishing accompanying operating and technical procedures.
  • Experience leading and developing teams

Bonus Points

  • Process Improvement or Lean Six Sigma training.
  • Leadership experience within health insurance operations

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 (accommodations@hioscar.com) 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.