Oscar Health · 2 hours ago
Senior Manager, Payment Integrity (Chart Review)
United States
Full-time
Remote
Senior Level
$111K/yr - $146K/yr
6+ years expOscar is a health insurance company built around a full stack technology platform focused on serving its members. The Senior Manager, Chart Review will lead the internal pre-payment chart review program, ensuring performance accountability and developing strategic plans for outcomes.
Health CareHealth InsuranceInsuranceInsurTech
Responsibilities
Lead, oversee, and grow Oscar's internal pre-payment chart review program
Lead a team to efficiently manage production inventory issues, ensuring achievement of production and quality targets
Anticipate, overcome, and prevent recurrence of complex problems and roadblocks in an efficient and effective manner
Establish routines that foster cross-functional collaboration with technology and data science teams to enhance chart review Key Performance Indicators (KPIs): hit rate, change rate, and other productivity metrics
Develop and implement standard Payment Integrity policies and procedures
Drive ideation of payment integrity opportunities
Participate in governance committee activities to ensure alignment with internal stakeholders & business decisions
Translate a strategic vision for the team and outline clear and measurable performance metrics / KPIs
Coach, develop and lead a team to achieve identified outcomes
Provide leadership in complex, cross-functional initiatives focused on claims improvement
Manage a portfolio of initiatives and deliverables and proactively identify areas of opportunity to improve key performance indicators
Compliance with all applicable laws and regulations
Other duties as assigned
Qualification
Required
6+ years experience in operations, data analytics and/or consulting within healthcare
6+ years of experience analyzing data to solve complex operational business problems
3+ years of experience leading an operations production team
3+ years experience designing, implementing and improving business workflows
Ability to execute on multiple high priority projects within tight deadlines
Preferred
Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA)
Process Improvement or Lean Six Sigma training, certification
Experience with healthcare claims processing
Experience managing in a healthcare claims organization
Experience using SQL
Benefits
Employee benefits
Participation in Oscar's unlimited vacation program
Annual performance bonuses
Medical, dental, and vision benefits
11 paid holidays
Paid sick time
Paid parental leave
401(k) plan participation
Life and disability insurance
Paid wellness time and reimbursements
Company
Oscar Health
Oscar is a health insurance company that offers individual and family plans, medicare advantages, and small group products.
1001-5000 employees
H1B Sponsorship
Oscar Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (19)
2024 (24)
2023 (22)
2022 (36)
2021 (13)
Funding
Current Stage
Public CompanyTotal Funding
$1.99BKey Investors
Tiger Global ManagementAlphabetFounders Fund
2025-09-16Post Ipo Debt· $355M
2021-03-03IPO
2020-12-17Private Equity· $140M
Leadership Team
Mark Bertolini
Chief Executive Officer
Steven B. Kelmar
Executive Vice President & COS
Recent News
2026-01-17
2026-01-16
2026-01-16
Company data provided by crunchbase