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Operations Team Lead - Clinical Review

| Greater NYC Area

What is the Position?

At Oscar, we work hard to provide the kind of health insurance we would want for ourselves. This means that we get to be creative and to build an excellent insurance operation from the ground up.

In this role, you will lead the local Clinical Review front line of non-clinical processors. Your job will be to set the processors up for success in their day to day jobs. You will set targets, communicate vitals and prioritization, and clear obstacles preventing processors from achieving targets each day.

Deliverables: What you have to achieve

During your first six weeks:

You have...

  • Developed a comprehensive understanding of the Clinical Review processes that currently exist and additional processes that are needed to improve consistency and quality.

  • Begun to form strong working relationships with internal and external stakeholders.

  • Created resources to support the team of processors grow in their content knowledge and problem solving skills

Afterwards and on an ongoing basis:

You continue to...

  • Become an inhouse expert on all Clinical Review related matters to answer questions on the scope and workflows

  • Make sure our day-to-day processes are executed in a timely and accurate manner.

  • Develop existing team members to take on new processes.

  • Support the processor team by identifying issues and presenting resolutions.

  • Contribute to team wide goals to improve Clinical Review processes and integrate additional functions into our daily operations.

Winning factors: What leads to success

Must-have qualifications and expertise include:

  • Drive.

  • Attention to detail.

  • Problem solving.

  • Process improvement orientation.

  • Experience managing teams.

  • Experience driving towards deliverables or metric based goals.

  • Willingness to grow, learn and work as a member of a cross-functional team.

  • Strong quantitative analysis skills.

  • Strong verbal and written communications, and interpersonal interactions (e.g. partnering, conflict management, consulting, etc.).

  • Ability to work independently and drive projects to completion.

We think it will make a big (positive) difference if you have...

  • A bachelor’s degree.

  • Knowledge of Clinical Review processing protocols and payment schemes.

  • Experience handling Personal Health Information (PHI) in a professional manner.

  • Experience manipulating and entering accurate data in a production driven environment.

  • Demonstrated capacity to balance competing priorities and continue to execute projects with excellence.

  • Proven track record in leading peers in organic and formal settings.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we work to cultivate an environment where exceptional people can be their most authentic selves and find both belonging and support. We're on a mission to change healthcare -- an experience made whole by your unique background and perspectives.

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.

Pay Transparency Policy: Oscar's Pay Transparency Policy ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.

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