Senior Analyst – Claims Production
| Company | Oscar Health |
|---|---|
| Location | Washington, USA, Pennsylvania, USA, Oregon, USA, Iowa, USA, California, USA, Washington, DC, USA, Vermont, USA, Texas, USA, Jackson Township, NJ, USA, Florida, USA, Waterbury, CT, USA, Nevada, USA, South Carolina, USA, Georgia, USA, Arizona, USA, Concord, NH, USA, Tennessee, USA, Virginia, USA, Arkansas, USA, Minnesota, USA, Colorado, USA, Kentucky, USA, New York, NY, USA, Maryland, USA, Maine, USA, Massachusetts, USA, Ohio, USA, Michigan, USA, Illinois, USA |
| Salary | $54000 – $78750 |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Senior |
Requirements
- A bachelor’s degree or 4+ years of commensurate health plan experience
- 3+ years experience in healthcare claims organization
- 3+ years experience working with large data sets using excel or a database language and root-cause analysis
- 3+ years experience deriving business insights from datasets and solving problems
- 3+ years experience improving business workflows and processes
- 3+ years experience collaborating with internal and/or external stakeholders
- 1+ years experience in operations or quality analytics
Responsibilities
- Ingest information from internal and external partners regarding adverse claim outcomes; collaborate with partners to scope, size, prioritize items and deliver solutions of complex claims issues.
- Translate observations, findings and analysis results into detailed–often technical–business requirements; submit to and collaborate with internal partners to effectuate change.
- Use insights from partner submissions, data mining, process monitoring, etc., work with the team to proactively identify thematic areas of opportunity to solve problems.
- Perpetuate a culture of transparency and collaboration by keeping stakeholders well informed of progress, status changes, blockers, completion, etc.; field questions as appropriate.
- Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc. whenever issues are escalated and assigned by leadership.
- Coordinate projects and processes to help ensure key milestones and service levels are met
- Partner with leadership to strategize, implement, and manage arrangements aimed at lowering overall cost or improving outcomes
- Partner with cross-functional teams to ensure action plans align with continuous improvement goals, and participate in collaboration with peers and cross-functional stakeholders
- Support the management, stewardship, and analysis of data to support compliant and performant business operations
- Provide recommendations that ensure financial discipline and quality
- Support identifying and implementing process improvement initiatives, as well as mindset shifts, to optimize operational efficiency and achieve performance targets
- Compliance with all applicable laws and regulations
- Other duties as assigned
Preferred Qualifications
- Knowledge management, training, or content development in operational settings
- Process Improvement or Lean Six Sigma training
- Experience using BigQuery or Looker Studio