Sr. Analyst, UM Regulatory Operations

Hi, we're Oscar. We're hiring a Senior Analyst to join our Utilization Management Regulatory 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 Senior Analyst, UM Regulatory Operations supports the design, optimization, and implementation of processes and improvements to operations to support achieving organizational goals. The Senior Specialist implements lean, repeatable and scalable tools and techniques and independently represent the team within the broader organization.

You will report to the UM Manager Regulatory Operations.

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 in the states of California, Connecticut, New Jersey, New York, and Washington is: $72,800 - $95,550 per year. The base pay for this role in all other locations is: $65,520 - $85,995 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities

• With support from leadership, help identify risks; respond to and resolve issues/errors/escalations through investigation to inform insights for short/medium/long-term technology-enabled processes and solutions
• Coordinate projects and processes to help ensure important milestones and service levels are met
• Partner with leadership to strategize, implement, and manage arrangements aimed at lowering overall cost or improving outcomes
• Partner with teams to ensure action plans align with continuous improvement goals, and participate in collaboration with peers and team members
• Support the management, stewardship, to support compliant and performant business operations
• Provide recommendations that ensure financial discipline and quality
• Support identifying and implementing process improvement projects, and mindset shifts, to optimize operational efficiency and achieve performance targets
• Compliance with all applicable laws and regulations
• Other duties as assigned

Qualifications

• 1+ years of professional experience in payer or provider healthcare contracting, provider network management, healthcare operations, or a related field
• 1+ years of experience using data and metrics to drive improvements
• 1+ years of experience in process improvement and workflow design
• 1+ years of experience in developing and presenting information and recommendations aimed at Senior Leadership

Bonus Points

• ACA marketplace, provider network, claims, healthcare quality, or provider data experience
• Management consulting experience
• Training or experience applying Continuous Process Improvement or Lean Six Sigma principles
• Experience with project coordination or management in a matrixed organization
• Experience supporting RFP development and implementation of software or service solutions

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Last updated on Aug 22, 2024