Data Analyst, Risk Adjustment

Data Analyst, Risk Adjustment

Hi, we're Oscar. We're hiring a Data Analyst to join our Risk Adjustment 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 focus on overseeing the encounter submission process to CMS (Centers for Medicare & Medicaid Services) for ACA and MA line of businesses. You'll build and refine data workflows to meet CMS deadlines. You'll identify inefficiencies and recommend tactical program improvements. You'll work cross functionally with the Data Science, Actuarial, and Value Capture teams on standing up our encounter submissions.

You will report into the Risk Adjustment Encounter Program Manager. This is a remote / work-from-home role. You must reside in one of the following states: Arizona, California, Connecticut, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, or Washington. Note, this list of states is subject to change. #LI-Remote

Responsibilities:

  • Build dashboards to monitor progress of Value Capture operations and encounter submissions
  • Integrate external data sources from providers, vendors, and healthcare partners into existing data workflows and systems
  • Identify errors in encounter submissions and triage solutions with Operations, Data Science, and other business stakeholders
  • Develop, scope, and automate Value Capture provider and ad hoc reporting
  • Help manage and optimize Oscar's Value Capture data infrastructure, analytics, and reporting
  • Coordinate with Engineering / Product to set up servers and ensure plan reference tables are correct for encounter submissions
  • Collaborate with the Data Science / Actuary team to ensure risk scores reconcile with internal CMS model and communicate findings with business stakeholders

Requirements:

  • 2+ years of SQL experience
  • 2+ years Advanced analytical skills
  • Experience diagnosing data problems, seeing patterns, and finding targeted solutions
  • Creatively problem-solve and fix hidden inefficiencies
  • Experience solving operational problems

Bonus points:

  • Experience with Python or other programing languages
  • Background in healthcare, tech, or risk adjustment

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here

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 aim to make health care affordable and accessible for all, and apply this same vision to our perks and benefits, including: medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, and volunteer opportunities.

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.

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.

To protect the health and safety of our employees, we require any employee conducting in-person work* to be fully vaccinated against COVID-19 by their start date. If you are unable to be vaccinated due to medical or protected religious reasons, please reach out to our Benefits team at accommodations@hioscar.com to submit an accommodations request.

*Note: In-person work includes: employees required to work from our offices, employees conducting sales work in the field and employees conducting at-home or in-person visits with members.

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