[Hiring] Director, Claims Operations, Process Improvement @Oscar Health

Role Description

You will lead a team in identifying and implementing process improvement opportunities in claims operations setting while ensuring we remain compliant and meet our contractual goals. You will be responsible for developing and implementing an operating plan for improving efficiency, scaling operations and ensuring the achievement of departmental performance metrics and goals. You will lead and execute key strategic initiatives that not only optimize workflows but also allow Oscar to stay competitive in the market.

You will report into the Senior Director, Claims.

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. #LI-Remote

Pay Transparency: The base pay for this role is: $162,453 - $213,220 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants, and annual performance bonuses.

Responsibilities

• Lead, coach and develop a high-performing team of managers and their reports
• Provide structure and support for your team, allowing them to keep their focus on delivering key initiatives
• Develop and continuously improve foundational processes
• Ensure operational compliance with all relevant regulatory/ accreditation agencies and meets contractual requirements
• Lead team to surface data, process, and technology issues through proactive identification, measurement, and monitoring of operations; partner cross functionally to develop end-to-end strategy that leverages these insights to scale
• Manage, develop and maintain relationships cross-functionally to drive multi department collaboration to drive results for strategic initiatives
• Own team vision and strategy including quarterly vital setting and multi-year roadmap
• Other duties as assigned

Qualifications

• Bachelor's Degree in related field or 4+ years of commensurate experience
• 10+ years experience in healthcare strategy and claims operations
• 6+ years of leadership experience
• 2+ years of experience in program management and/or process design or implementation
• 3+ years of experience analyzing data to solve complex operational business problems
• 3+ years experience designing, implementing and improving business workflows
• Experience with healthcare claims processing

Bonus Points

• Master's degree
• Health Insurance, or Management Consulting experience with a focus on healthcare
• Lean / Six Sigma experience
• Financial modeling experience

Benefits

• Medical, dental, and vision benefits
• 11 paid holidays
• Paid sick time
• Paid parental leave
• 401(k) plan participation
• Life and disability insurance
• Paid wellness time and reimbursements