Associate Director, Insurance Operations - Claims (Remote)

Oscar Health

Pennsylvania

United States

Customer Service / Call Center
(No Timezone Provided)

Hi, we're Oscar. We're hiring an Associate Director to join our Insurance Operations 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 Claims Process Design & Strategy team at Oscar ensures claims adjudication, manages supporting processes, and services our partners. We design and improve operations in our department using technology and process-based solutions to achieve outstanding performance, and differentiate Oscar from our competitors.

You will have end-to-end oversight for the design, improvement and implementation of operational processes that allow us to adjudicate claims, achieve unique capabilities to our claims platform, and hit expansion targets. You and your team will do this by working with partners across the organization to take your ideas from vision to implementation.

You will report to the Director, Insurance Operations. This is a remote role, you will work remotely in one of the following states: Arizona, California, Connecticut, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, or Washington. Note, this list of states is subject to change.

Responsibilities

  • Coach a team of managers and their reports
  • Provide structure and support for your team, allowing them to keep their focus on delivering plans
  • Work with technical partners to provide the next generation of health insurance operations
  • Become a trusted partner to our Insurance organization and sales partners, allowing delivery of growth and expansion targets
  • Develop and reengineer foundational processes for scaling our claims operations and summarize the complexity of our data and operations into clear explanations
  • Lead team to surface data, process, and technology issues through identification, measurement, and monitoring of our operations; partner to develop end-to-end strategy that uses these insights to grow
  • Manage team strategy including quarterly goal setting and multi-year roadmap
  • Support your team and leadership by guiding decisions and implementation on an ongoing basis
  • Qualifications

  • A bachelor's degree or 4 years of operations experience
  • 8+ years of work in health plan operations, health insurance, or data analysis or consulting in the healthcare space
  • 5+ years of experience building and developing operational teams
  • Experience developing project plans coordinating with all partners
  • Experience designing and improving workflows and standing up accompanying operating and technical procedures
  • Strong analytical decision-making and organizational skills.
  • Expert in Excel / Google Sheets (can write advanced macros)
  • Bonus Points

  • Process Improvement or Lean Six Sigma training
  • Experience with claims processing
  • Proficient in SQL
  • Startup experience
  • Life at Oscar

    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.

    We encourage our members to care for their whole selves, and we encourage our employees to do the same with comprehensive medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, and volunteer opportunities.

    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.

    Pay Transparency Policy

    Oscar ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.

    COVID-19 vaccine requirements for in-person work:

    To protect the health and safety of our employees, we require any employee conducting in-person work* to be fully vaccinated against COVID-19 by their start date. 

    If you are unable to be vaccinated due to medical or protected religious reasons, please reach out to our Benefits team at [email protected] to submit an accommodations request.

    *Note: In-person work includes: employees required to work from our offices (either full-time or part-time), employees conducting sales work in the field and employees conducting at-home or in-person visits with members.

    Associate Director, Insurance Operations - Claims (Remote)

    Oscar Health

    Pennsylvania

    United States

    Customer Service / Call Center

    (No Timezone Provided)

    Hi, we're Oscar. We're hiring an Associate Director to join our Insurance Operations 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 Claims Process Design & Strategy team at Oscar ensures claims adjudication, manages supporting processes, and services our partners. We design and improve operations in our department using technology and process-based solutions to achieve outstanding performance, and differentiate Oscar from our competitors.

    You will have end-to-end oversight for the design, improvement and implementation of operational processes that allow us to adjudicate claims, achieve unique capabilities to our claims platform, and hit expansion targets. You and your team will do this by working with partners across the organization to take your ideas from vision to implementation.

    You will report to the Director, Insurance Operations. This is a remote role, you will work remotely in one of the following states: Arizona, California, Connecticut, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, or Washington. Note, this list of states is subject to change.

    Responsibilities

  • Coach a team of managers and their reports
  • Provide structure and support for your team, allowing them to keep their focus on delivering plans
  • Work with technical partners to provide the next generation of health insurance operations
  • Become a trusted partner to our Insurance organization and sales partners, allowing delivery of growth and expansion targets
  • Develop and reengineer foundational processes for scaling our claims operations and summarize the complexity of our data and operations into clear explanations
  • Lead team to surface data, process, and technology issues through identification, measurement, and monitoring of our operations; partner to develop end-to-end strategy that uses these insights to grow
  • Manage team strategy including quarterly goal setting and multi-year roadmap
  • Support your team and leadership by guiding decisions and implementation on an ongoing basis
  • Qualifications

  • A bachelor's degree or 4 years of operations experience
  • 8+ years of work in health plan operations, health insurance, or data analysis or consulting in the healthcare space
  • 5+ years of experience building and developing operational teams
  • Experience developing project plans coordinating with all partners
  • Experience designing and improving workflows and standing up accompanying operating and technical procedures
  • Strong analytical decision-making and organizational skills.
  • Expert in Excel / Google Sheets (can write advanced macros)
  • Bonus Points

  • Process Improvement or Lean Six Sigma training
  • Experience with claims processing
  • Proficient in SQL
  • Startup experience
  • Life at Oscar

    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.

    We encourage our members to care for their whole selves, and we encourage our employees to do the same with comprehensive medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, and volunteer opportunities.

    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.

    Pay Transparency Policy

    Oscar ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.

    COVID-19 vaccine requirements for in-person work:

    To protect the health and safety of our employees, we require any employee conducting in-person work* to be fully vaccinated against COVID-19 by their start date. 

    If you are unable to be vaccinated due to medical or protected religious reasons, please reach out to our Benefits team at [email protected] to submit an accommodations request.

    *Note: In-person work includes: employees required to work from our offices (either full-time or part-time), employees conducting sales work in the field and employees conducting at-home or in-person visits with members.