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Hi, we're Oscar. We're hiring a Director, Process Improvement to join our Claims 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 Director, Process Optimization will lead a team in identifying and implementing training, claims process document and process improvement opportunities while ensuring compliance and meeting contractual goals. You will be responsible for developing and implementing an operating plan for improving efficiency, scaling operations and ensuring the achievement of departmental performance metrics and goals. The Director will lead and execute key strategic initiatives that not only optimize workflows but also allow Oscar to stay competitive in the market.
You will report to the Senior Director, Claims.
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, Arkansas, 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: $158,400 - $207,900 per year. The base pay for this role in all other locations is: $142,560 - $187,110 per year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program, company equity grants and annual performance bonuses.
Responsibilities
- Maintain responsibility for the continuous improvement of claims processing procedures and ensure adherence to established claims operations procedures throughout the organization
- Lead a team in the optimization of claims process documentation, and development and execution of claims department training
- Collaborate with Operations and Technology team leadership to identify and implement claims system performance strategies
- Lead creation of short- and long-term roadmap planning process to meet organization goals, identifying important resources and requirements to meet plans' goals
- Establish and monitor measures to ensure compliance with industry regulations, internal policies and best practice principles around claims processing
- Work with internal tech partners to ensure a coordinated approach in leadership of claims processing, training, performance monitoring, system and process optimization and technology
- Lead, coach and develop a high-performing team of managers and their reports
- Develop and continuously improve foundational processes
- Ensure operational compliance with all relevant regulatory/ accreditation agencies and meets contractual requirements
- Lead team to surface data, process, and technology issues through proactive identification, measurement, and monitoring of operations; partner cross functionally to develop end-to-end strategy that leverages these insights to scale
- Manage, develop and maintain relationships cross-functionally to drive multi department collaboration to drive results for strategic initiatives
- Own team vision and strategy including quarterly vital setting and multi-year roadmap
- Compliance with all applicable laws and regulations
- Other duties as assigned
Qualifications
- Bachelor's Degree in related field or 4+ years of commensurate experience
- 10+ years of experience in healthcare strategy and operations, and or related field
- 6+ years of leadership experience
- 2+ years of experience in program management and/or process design or implementation
- 10+ years of experience in a cross-functional operations environment
- 3+ years of experience working at a health plan/payer
Bonus Points
- Master’s degree
- Lean / Six Sigma experience
- Financial modeling experience
- Extensive knowledge of claims operations and processing, insurance products, contracts, and regulatory and policy language
- Experience working with technical teams (i.e. engineering and product) to communicate our requirements, design tooling, and support technical troubleshooting
- Experience forming data-driven, concrete answers in a world with imperfect information
- Proficient in technical writing
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 ([email protected]) to make the need for an accommodation known.
Artificial Intelligence (AI) Guidelines: Please see our AI Guidelines for the acceptable use of artificial intelligence during the interview process at Oscar.
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.
Oscar Health New York, New York, USA Office
New York, NY, United States, 10013
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