Senior Analyst, Claims Configuration

Senior Analyst, Claims Configuration

Hi, we're Oscar. We're hiring a Senior Data Analyst to join our Insurance Operations 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:

At Oscar, we are working to provide the kind of health insurance we would want for ourselves. This means that we get to be creative and build an excellent insurance operation from the ground up. You will have the potential for tremendous growth and leadership opportunities as we scale and expand into new markets. We are looking for people who are excited to grow with us.

As a Sr. Configuration Analyst at Oscar, you will do everything necessary to help us build a solid operational foundation. Your configurations guarantee automated and accurate payments to cement Oscar's position as a speed-to-payment and payment accuracy leader. You will partner across technical and policy teams including network, claims, data, and engineering with leadership exposure.

You will report to the Operations 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

  • Become the subject matter expert for health insurance contracts and pricing/configuration workflows
  • Assess and implement new and updated contractual obligations and reimbursement policies into automated processing-logic
  • Develop insights into opportunities for workflow improvements
  • Become super users with internal tools and technical processes, in particular database querying and Python and Ruby-like contract logic configuration
  • Systematically identify the technological and process factors that prevent successful automated pricing/benefits
  • Lead working relations with diverse partners and stakeholders
  • Support your team lead or manager by guiding decisions and implementation on an ongoing basis
  • Understand relevant policies, and identify and measure the impact of any changes on our internal operations

Requirements

  • 2+ years of related work experience in healthcare analytics or coding/back-end development
  • 2+ years experience with SQL, Python, or similar database languages
  • Experience backend troubleshooting pricing and benefits of medical claims based on payer-provider contracts
  • Proficiency in Google/Microsoft Office Suite

Bonus Points

  • Bachelor's degree

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.

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.

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.

COVID-19 vaccine requirements for in-person work:

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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