Oscar Health

Oscar Health

7 open positions available

3 locations
1 employment type
Actively hiring
Full-time

Latest Positions

Showing 7 most recent jobs
OH

Senior Project Manager, Network Operations

Oscar HealthTempe, ArizonaFull-time
View Job
Compensation$118K - 155K a year

Leading cross-functional projects to optimize healthcare operational processes, ensuring compliance, and reporting to senior leadership. | Extensive experience in healthcare program and project management, change management, and solving health plan operational problems, with a preference for healthcare-specific experience. | Hi, we're Oscar. We're hiring a Senior Project Manager to join our Network Operations 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: The Senior Project Manager is a key leadership role responsible for driving end-to-end operational excellence by managing, maintaining, and overseeing significant projects and strategic initiatives across the company. This individual leverages subject matter expertise and a cross-functional lens to lead and coordinate multiple large work groups, ensuring efficient, repeatable processes that reduce operational, financial, compliance, and regulatory risks, resulting in a sound program. A core responsibility is leading efforts in program standardization, operationalization, and issue resolution, including root cause analysis, while developing, presenting, and maintaining executive reporting materials to keep senior leadership informed. Furthermore, the Senior Project Manager identifies risks, drives improvement opportunities for new programs, maintains compliance with all applicable laws and regulations, and organizes critical program documentation like meeting notes and decisions. You will report into the Director, Process Improvement. Work Location: This position is based in our Tempe, Arizona 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. #LI-Hybrid Pay Transparency: The base pay for this role is: $118,080 - $154,980 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Using a cross-functional lens and subject matter expertise, drive end-to-end operational excellence, measuring, monitoring, and executing to reduce operational, financial, compliance and regulatory risks and to ensure efficient, repeatable processes leading to a sound program. Manage large, multiple cross-functional work groups that support and optimize end-to-end program process while improving visibility into internal processes Lead, oversee, and coordinate the various projects, products and strategic initiatives Leverage subject matter expertise to drive targeted program standardization, operationalization, and issue resolution and/or root cause analysis efforts while collaborating with key internal stakeholders to optimize efficiency, including training resources and other key process decisions Develop, present, and maintain executive reporting materials to educate, inform, and update senior leadership teams on programs, projects, and strategic contracting initiatives Develop subject matter expertise in methodologies, major terms, and associated operations required for program execution Identify risks and improvement opportunities to develop and implement new programs Organize and catalog meeting notes, action items, decisions made, and follow-ups in leadership meetings, or as needed Other contracting and operational implementation as assigned Compliance with all applicable laws and regulations Other duties as assigned Requirements: Bachelor's Degree or 4+ years of commensurate experience 6+ years of program and project management in the healthcare space 6+ years experience in change management and process improvement and implementation 6+ years of experience solving health plan operational problems Bonus points: Experience working within a rapidly scaling organization Masters in Business Administration or healthcare related field(s) Experience with google suite (Sheets, Docs, etc.) 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. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. 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 (accommodations@hioscar.com) to make the need for an accommodation known. 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 Privacy Policy.

Program Management
Operational Excellence
Change Management
Process Improvement
Strategic Leadership
Direct Apply
Posted 5 days ago
Oscar Health

Senior Project Manager, Network Operations

Oscar HealthAnywhereFull-time
View Job
Compensation$118K - 155K a year

Drive operational excellence, manage large cross-functional projects, develop executive reports, and identify improvement opportunities. | 6+ years in healthcare program management, change management, and solving health plan operational problems, with a bachelor's degree or equivalent experience. | Hi, we're Oscar. We're hiring a Senior Project Manager to join our Network Operations 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: The Senior Project Manager is a key leadership role responsible for driving end-to-end operational excellence by managing, maintaining, and overseeing significant projects and strategic initiatives across the company. This individual leverages subject matter expertise and a cross-functional lens to lead and coordinate multiple large work groups, ensuring efficient, repeatable processes that reduce operational, financial, compliance, and regulatory risks, resulting in a sound program. A core responsibility is leading efforts in program standardization, operationalization, and issue resolution, including root cause analysis, while developing, presenting, and maintaining executive reporting materials to keep senior leadership informed. Furthermore, the Senior Project Manager identifies risks, drives improvement opportunities for new programs, maintains compliance with all applicable laws and regulations, and organizes critical program documentation like meeting notes and decisions. You will report into the Director, Process Improvement. Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $118,080 - $154,980 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Using a cross-functional lens and subject matter expertise, drive end-to-end operational excellence, measuring, monitoring, and executing to reduce operational, financial, compliance and regulatory risks and to ensure efficient, repeatable processes leading to a sound program. • Manage large, multiple cross-functional work groups that support and optimize end-to-end program process while improving visibility into internal processes • Lead, oversee, and coordinate the various projects, products and strategic initiatives • Leverage subject matter expertise to drive targeted program standardization, operationalization, and issue resolution and/or root cause analysis efforts while collaborating with key internal stakeholders to optimize efficiency, including training resources and other key process decisions • Develop, present, and maintain executive reporting materials to educate, inform, and update senior leadership teams on programs, projects, and strategic contracting initiatives • Develop subject matter expertise in methodologies, major terms, and associated operations required for program execution • Identify risks and improvement opportunities to develop and implement new programs • Organize and catalog meeting notes, action items, decisions made, and follow-ups in leadership meetings, or as needed • Other contracting and operational implementation as assigned • Compliance with all applicable laws and regulations • Other duties as assigned Requirements: • Bachelor's Degree or 4+ years of commensurate experience • 6+ years of program and project management in the healthcare space • 6+ years experience in change management and process improvement and implementation • 6+ years of experience solving health plan operational problems Bonus points: • Experience working within a rapidly scaling organization • Masters in Business Administration or healthcare related field(s) • Experience with google suite (Sheets, Docs, etc.) 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. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. 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 (accommodations@hioscar.com) to make the need for an accommodation known. 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 Privacy Policy.

Program and project management
Change management
Process improvement
Operational risk reduction
Cross-functional team leadership
Verified Source
Posted 6 days ago
OH

Associate, Virtual Care

Oscar HealthNew York, New YorkFull-time
View Job
Compensation$Not specified

Providing non-medical, companion care including assistance with daily routines, hygiene, medication reminders, and light housekeeping. | Must have healthcare certifications such as HHA, CNA, or PCA, and experience in caregiving. | Hi, we're Oscar. We're hiring a ((TITLE)) to join our ((TEAM NAME)). 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: ((Write one or two sentences that describe the team the candidate will work on. Use “We” statements when talking about Oscar.)) ((Write two or three sentences that describe the overall scope of the role. Use “You” statements when talking about the role.)) You will report into the ((MANAGER TITLE)). Work Location: This position is based in our ((OFFICE LOCATION)) 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. #LI-Hybrid Pay Transparency: The base pay for this role is: $((80% CompaRatio)) - $((105% CompaRatio)) per ((year)). You are also eligible for employee benefits, ((monthly vacation accrual at a rate of 15 days per year)) ((participation in Oscar's unlimited vacation program)) ((company equity grants)) and ((annual performance bonuses)) ((sales commissions)). Responsibilities: ((Add 4-5 key responsibilities of the job)) ((Each bullet should start with an action verb)) ((List responsibilities in order of importance)) ((This list does not need to be exhaustive, focus on the main or important responsibilities)) Requirements: ((List 4-5 basic qualifications (BQs) for this role.)) ((BQs can be identified in the application - not assumed.)) ((BQs can be identified without reviewing other applications)) ((EX: 5+ years of experience in banking or Experience leading teams)) ((Avoid soft skills like "excellent written and verbal communication skills")) Bonus points: ((List 2-3 preferred qualifications (PQs) for this role)) ((PQs enhance the candidate's ability to do the job but aren't required)) ((EX: Experience in a tech/start-up environment)) 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. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. 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 (accommodations@hioscar.com) to make the need for an accommodation known. 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 Privacy Policy.

Healthcare certifications (HHA, CNA, PCA)
Direct Apply
Posted 10 days ago
Oscar Health

Senior Manager Forecasting & Planning

Oscar HealthAnywhereFull-time
View Job
Compensation$130K - 170K a year

Lead forecasting and planning team to deliver accurate volume and staffing projections, develop forecasting models, manage stakeholders, and drive continuous improvement. | Requires 4+ years forecasting/modeling, 6+ years SQL or Python, 3+ years team management, and experience in business/operations planning and stakeholder management. | Hi, we're Oscar. We're hiring a Senior Manager Forecasting & Planning to join our Operational Forecasting 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 key component of Oscar's operational forecasting team. You will deliver accurate, data-driven volume and staffing projections across key business lines. You will develop and implement forecasting models, methodologies, and governance to optimize operational efficiency and financial performance. You will oversee a team of associates and partner cross-functionally with Operations, Finance, and Workforce Management to align forecasts with strategic objectives. You will drive continuous improvement in forecast accuracy, analytics capability, and stakeholder confidence through innovation and key collaborative relationships. You will report into the Senior Director, Production Resource Management. Work Location: This is a remote position, open to candidates who reside in: Dallas, Texas. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. Pay Transparency: The base pay for this role is: $129,600 - $170,100 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities • Manage stakeholder relationships and expectations and actively keeps them informed of the status of open/queued requests. Gathers feedback and drives improvements in the operating model • Help package multiple analyses into a cohesive recommendation for the business • Engage with senior leadership at various levels on matters concerning related functional areas and makes recommendations for executive decision-making • Implement processes and practices that drive improvement in the team's execution, and works with incomplete / ambiguous information • Drive the strategy and culture for the team to be effective and aligned with the enterprise's objectives • Understand the use, flow, and generation of data within a complex ecosystem of business processes articulates findings to audiences with varying degrees of technical knowledge • Manage, coaches, develops a team of high performing data analysts. Drives a positive team culture, high-quality work, accomplishments and recognition • Help clear strategic and tactical roadblocks for the team and enable timely delivery of high-quality work products to stakeholders • Project manages the team's analytical deliverables and ensures KPIs/SLAs are met • Partner with Associate Director / Director in setting vision and goals for the team • Enhance essential operational and analytical dashboards, and define the requirements to enhance them as our users' needs evolve • Identify opportunities to create models and tools that streamline processes and overall drive efficiencies within the organization • Compliance with all applicable laws and regulations • Other duties as assigned Requirements • 4+ years of technical work experience in forecasting and/or modeling • 2+ years of experience in business/operations planning • 3+ years in a client-facing role with experience managing issues with stakeholders • 4+ years demonstrated ability to work with large datasets and distill analyses into relevant insights with a structured and systematic thought process • 6+ years experience in SQL, with the ability to filter, aggregate, and build CTEs, or proficiency in R or Python, including experience with Pandas, for loops, and statistical tests • 6+ years experience, including proficiency in Google Sheets or Excel skills, with ability to use VLookup, nested if statements and connected Sheets • 3+ years experience in managing, coaching and developing teams Bonus Points • 4+ years experience in preparing healthcare analytics, reporting, and data management • Experience with ticketing system (such as Jira, Appian) • 2+ years experience developing dashboards and working with Looker, or other business intelligence/data visualization tools • 3+ years experience in verbal and written communication, of business analysis/reporting impact and requirements • 3+ years experience in healthcare, finance or the insurance industry 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. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. 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 (accommodations@hioscar.com) to make the need for an accommodation known. 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 Privacy Policy.

Forecasting
Operational Planning
Stakeholder Management
SQL
Python
Google Sheets/Excel
Team Management
Data Analysis
Business Intelligence
Verified Source
Posted 11 days ago
Oscar Health

Manager, Strategic Initiatives

Oscar HealthAnywhereFull-time
View Job
Compensation$84K - 111K a year

Lead and coordinate cross-functional program implementation, ensure operational efficiency, establish governance, and manage stakeholder collaboration to achieve strategic initiatives. | 4+ years of program/project management and change management experience in health insurance, with strong skills in process improvement and stakeholder engagement. | Hi, we're Oscar. We're hiring a Manager, Strategic Initiatives to join our Enterprise Delivery 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 be responsible for leading all activities related to program implementation goals to ensure success of large cross-functional programs. You will identify and drive strategic improvements for core operations, including proper controls and monitoring, ensuring operational efficiency and effectiveness. You will oversee and coordinate the program across the organization to implement project management fundamentals across the organization, including establishing efficient governance structures to track progress and ensure appropriate levels of visibility. As a member of the Enterprise Delivery team, you will support business and operations partners in decision making, ensuring collaborative working models, being Oscar's connective tissue to inform work and identify critical interdependencies. You will report into the Senior Director, Strategic Implementation. Work Location: This is a remote position, open to candidates who reside in: Dallas, TX. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. Pay Transparency: The base pay for this role is: $84,240 - $110,565 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities • Organize and lead daily activities for your programs, often acting as the translators of strategy into actionable plans • Identify, develop and implement program strategy, optimizations and tooling that support the organization's objectives • Meet with stakeholders to discuss program status and goals, [helping to guide decisions and creating recommendations when needed] • Oversee implementations end to end to ensure program success [including guiding the development of KPIs and reporting for all levels of the organization] • [Heavy collaboration and partnership] with other departments and various stakeholders to ensure [strategic and] operational excellence • Analyze program risks; ability to anticipate risks and issues. This includes proactive flagging of issues, managing escalations, and tracking and helping to resolve risks and issues. • Ensure proper controls and monitoring are in place for the your program (e.g. management processes and governance structures) • Work with leadership and the program stakeholders to lead program retrospectives and assess program strengths and weaknesses • Ensure proper metrics are in place to measure program success • Compliance with all applicable laws and regulations • Other duties as assigned Requirements • 4+ years of program and project management in the health insurance space • 4+ years experience in change management and process improvement Bonus Points • Healthcare experience • Management consulting 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 (accommodations@hioscar.com) 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.

Program Management
Project Management
Change Management
Process Improvement
Stakeholder Management
Governance Structures
Risk Analysis
Healthcare Industry Knowledge
Verified Source
Posted 2 months ago
Oscar Health

Senior Specialist, Coding Auditor

Oscar HealthAnywhereFull-time
View Job
Compensation$57K - 83K a year

Audit prepayment and post payment medical claims to detect fraud, waste, and abuse, develop expertise in coding guidelines, document findings, and support team efficiency and training. | 1+ years auditing experience in multiple specialties, Certified Professional Coder (CPC) certification required, bachelor's degree or 4+ years work experience, with bonus points for fraud and healthcare knowledge. | Hi, we're Oscar. We're hiring a Senior Specialist, Coding Auditor to join our SIU 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 Senior Specialist works to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to audit prepayment and/or post payment claims. The Senior Specialist runs and coordinates activities across Oscar to reduce the incidence and effect of fraud, waste, and abuse (“FWA”) on all our operations. You will report to the Manager, SIU Coding Audit Post-Pay. 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. This is a remote position, open to candidates who reside in the following location(s): 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. While your day-to-day work will be completed from your home office, occasional travel may be required for key team meetings and company events. Pay Transparency The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $63,200 - $82,950 per year. The base pay for this role in all other locations is: $56,800 - $74,655 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities • Develop and maintain a depth of expertise on CPT, HCPCS, and ICD-10 Coding guidelines and other insurance billing submission requirements. • Perform complex policy updates or audits of assigned documentation (i.e. medical records or claims) on both a prepayment and/or post payment basis to determine accuracy of claims submitted to Oscar. • Document findings including reference to sources used to support decision-making and in a way that can be easily understood by non clinicians or coders. • Create reports and reference guides that can be used by other team members to communicate findings or more effectively perform similar reviews. • Help draft written communications to providers to convey findings. • Participate in educational calls with providers. • Help train new team members. • Develop and document processes to improve the efficiency of the team. • Compliance with all applicable laws and regulations • Other duties as assigned Qualifications • 1+ years of auditing experience across multiple specialties. • Certified Professional Coder (CPC) designation or similar certification (required for SIU) • Bachelor's degree or 4+ years of work experience Bonus Points • Certified Professional Medical Auditor • Additional certification applicable to this work such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] and Fraud Professional (CAFP), other coding certifications or similar • Knowledge of applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity • Demonstrated experience translating technical jargon to non-technical end users. • Experience working in health insurance specifically with claims processing, billing, reimbursement, or provider contracting. • Experience with HIPAA, data privacy, and/or data security processes • Experience working with regulators governing (public or private) health insurance carriers 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 (accommodations@hioscar.com) 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.

CPT coding
HCPCS coding
ICD-10 coding
Medical claims auditing
Policy updates
Report writing
Provider communication
Team training
Compliance
Verified Source
Posted 3 months ago
Oscar Health

Program Manager, Case Management

Oscar HealthAnywhereFull-time
View Job
Compensation$89K - 129K a year

Manage clinical programs end-to-end including project planning, stakeholder management, data evaluation, and continuous improvement. | 3+ years program management experience, ability to independently create projects, use data for program improvement, and implement enterprise-wide initiatives. | Hi, we're Oscar. We're hiring an Associate to join our Case Management Programs 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 You will own one or more clinical programs, working cross functionally with internal and external Oscar stakeholders while representing the needs and interests of the department. We ask that you have program design, initiative implementation, with an ability to work across disparate initiatives and stakeholders at the same time. You will work with a clinical dyad partner to manage the assigned clinical programs. You will report to the Senior Manager, Case Management Programs. 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: $98,400- $129,150 per year. The base pay for this role in all other locations is: $88,560 - $116,235 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities • Oversee and identify optimization and continuous improvement of program(s). • Lead the end-to-end management of implementations/projects, including detailed project plan creation, stakeholder engagement, and management of cross-functional relationships. • Evaluate overall departmental performance by creating, gathering, analyzing and interpreting data. • Work with all relevant internal and external stakeholder groups to formulate implementation, communications, and program strategies for successful change management and risk mitigation initiatives. • Expert in program(s) who can present to senior leadership on workflow decisions, metrics, and program value. • Mentor team members and promotes colleagues' professional development • Compliance with all applicable laws and regulations • Other duties as assigned Qualifications • 3+ years of experience in program management and program design • 2+ years of experience in creating projects / programs independently and within a team environment • Experience using data to improve programs • Experience implementing enterprise-wide initiatives: defined project plans, coordinated resources, managed implementation activities, and developed all processes associated with program rollout and ongoing support Bonus Points • Experience / background in a fast-paced operations environment • Master's Degree • PMP Certifications or Program Management Certifications • Lean/Six Sigma Certifications • Healthcare experience (Health Insurance, Health Systems, or Healthcare Consulting) 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 (accommodations@hioscar.com) 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.

Program Management
Project Implementation
Data Analysis
Stakeholder Engagement
Change Management
Compliance
Mentoring
Verified Source
Posted 5 months ago

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