Oscar Health · 1 day ago

Claims Quality Senior Analyst

United States

Full-time

Remote

Mid, Senior Level

$73K/yr - $96K/yr

3+ years exp

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Responsibilities

Ingest information from internal and external partners regarding adverse claim outcomes; collaborate with partners to scope, size, prioritize items and deliver solutions.

Utilize data analysis skills and tools to develop accurate, quantitative analyses of claims issues.

Translate observations, findings and analysis results into business requirements; submit to and collaborate with internal partners to effectuate change.

Use insights from partner submissions, data mining, process monitoring, etc., work with the team to proactively identify thematic areas of opportunity to solve problems.

Perpetuate a culture of transparency and collaboration by keeping stakeholders well informed of progress, status changes, blockers, completion, etc.; field questions as appropriate.

Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc. whenever issues are escalated and assigned by leadership.

Compliance with all applicable laws and regulations

Other duties as assigned

Qualification

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Claims processingBusiness workflows improvementStakeholder collaborationSQLProcess ImprovementLean Six SigmaData analysisHealthcare operationsKnowledge managementContent developmentData backgroundHealthcare backgroundEngineering background