Senior 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, 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.

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
  
  

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.