Oscar Health · 22 hours ago

Operations Associate, Claims Design

United States

Full-time

Remote

Entry, Mid Level

$98K/yr - $129K/yr

3+ years exp

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Responsibilities

Designs and prioritizes operational processes by working cross functionally to gather business requirements and implementing process- and technology-enabled solutions

Leads and cross collaborates on iterative problem definition and technical design and scoping to build solutions with the end-user in mind

Utilizes data to independently drive business decisions, impact cross-functional strategy and develop KPIs to measure the effectiveness of your domain

Serve as a subject matter expert in the claims payments and overpayments process within the claims lifecycle

Proactively identifies risks; responds to and resolves issues/errors/escalations through data-driven investigation to produce insights for short, medium, and long-term technology-enabled solutions

Distills the requirements of new product and market expansions and designs automated workflows to reduce manual work requirements

Works with engineers, analysts and other Operations team members to resolve escalations, develop training, and create technical tooling to enable others

Understands the operations ecosystem, technology and data models; its current strengths, weaknesses, and gaps; and connects the dots for other teams

Compliance with all applicable laws and regulations

Other duties as assigned

Qualification

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Data software (SQL)Data software (Python)Claims adjudicationTechnical role experienceAnalytics experienceWorkflow designProcess ImprovementLean Six Sigma trainingHealthcare experienceCoding backgroundMath backgroundStatistics backgroundData science backgroundKnowledge managementTraining developmentContent developmentEngineering background