Hi, we're Oscar. We’re hiring an Operations Analyst to join our Value Capture team in our New York office.
Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, transparent, and human. We need your help to do so.
About the role:
This role assists in key operations for Value Capture by focusing on supporting Risk Adjustment and RADV (Risk Adjustment Data Validation) initiatives. Working with both our vendors and internal stakeholders to support analytics and reporting within the operations team for risk adjustment.
You will work closely with other departments to guarantee regulatory compliance and improve performance on risk adjustment audits for ACA and MA. In this role you’ll build and refine workflows while also tracking progress to meet critical CMS deadlines.
You’ll help manage data for health systems, vendor partners, and internal stakeholders.
You will report into the Value Capture Program Manager
- Build dashboards to monitor progress of Value Capture programs and escalate issues with key stakeholders.
- Triage chart retrieval issues from vendors and build tools/workflows to assist in obtaining charts.
- Lead the execution of all RADV deliverables for documentation and validation of member enrollments, collection of charts, white papers and ad-hoc requests to ensure audit submissions
- Establish relationships with internal and external stakeholders to foster an increased understanding of the audit process
- Manage vendor and project manage our IVA and downstream coding teams
- Review current retrieval processes and audit procedures to get ready for Risk Adjustment Data Validation (RADV).
- Build out coding performance reports for provider partners based on CMS and RADV coding performance
- 2+ years experience with SQL
- Experience managing vendor relationships
- Bachelors in Business, Data Analytics, Health Administration or related field or equivalent experience
Life at Oscar:
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.
We encourage our members to care for their whole selves, and we encourage our employees to do the same with comprehensive medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, and volunteer opportunities.
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@example.com) to make the need for an accommodation known.
Pay Transparency Policy:
Oscar 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.