Director, Claims Operations, Process Improvement

Hi, we're Oscar. We're hiring a Director, Claims Operations, Process Improvement to join our Claims Production team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless 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

You will lead a team in identifying and implementing process improvement opportunities in claims operations setting while ensuring we remain compliant and meet our 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.You 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 into the Senior Director, Claims.

Work Location: This position is based in our New York City office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule.

Pay Transparency: The base pay for this role is: $180,504 - $236,911.50 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants, and annual performance bonuses.

Responsibilities

• Lead, coach and develop a high-performing team of managers and their reports
• Provide structure and support for your team, allowing them to keep their focus on delivering key initiatives
• 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
• Other duties as assigned

Requirements

• Bachelor's Degree in related field or 4+ years of commensurate experience
• 10+ years experience in healthcare strategy and claims operations
• 6+ years of leadership experience
• 2+ years of experience in program management and/or process design or implementation
• 3+ years of experience analyzing data to solve complex operational business problems
• 3+ years experience designing, implementing and improving business workflows
• Experience with healthcare claims processing

Bonus Points

• Master's degree
• Health Insurance, or Management Consulting experience with a focus on healthcare
• Lean / Six Sigma experience
• Financial modeling experience

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.

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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.

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