[Hiring] Associate, Inquiries and Investigations @Oscar Health

Role Description

The Associate, Inquiries and Investigations is responsible for working cross-functionally with business and technical Oscar stakeholders to solve data process challenges and represent departmental interests in company-wide strategic initiatives. The position leads implementations and data corrections to enhance processes that directly impact directory accuracy and filing submissions. Primary focus is placed on investigating and resolving complex escalations/inquiries through production release, while driving comprehensive process documentation, maintaining project plans, and implementing risk mitigation strategies to ensure quality and financial discipline.

You will report into the Senior Manager, Provider Data Operations.

Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia. 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.

Pay Transparency: The base pay for this role is: $87,188 - $114,434 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities

• Leads the end-to-end management of cross-functional implementations and projects—including project plan creation, stakeholder engagement, edge case mitigation, and on-time completion—to enhance processes and execute data corrections that directly impact directory accuracy and filing submissions.
• Evaluates departmental performance by creating, gathering, analyzing, and interpreting data to inform technology-enabled solutions, establish departmental key metrics, and implement mitigation strategies that ensure quality and financial discipline.
• Collaboratively works with leadership, peers, and internal/external stakeholders to investigate risks and escalations, formulate proactive strategies, and partner across teams on continuous improvement action plans through final release to production.
• Mentors team members and promotes colleagues' professional growth, fostering team collaboration and driving mindset shifts necessary to optimize operational efficiency and achieve departmental targets.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Qualifications

• A bachelor's degree or 3+ years commensurate experience.
• 3+ years of professional experience in payer or provider healthcare contracting, provider network management, healthcare operations, or a related field.
• 2+ years of experience using data software such as Excel, SQL or other data analytics tools.
• 2+ years of experience with end to end project management.
• 2+ years of experience in designing and improving workflows as well as standing up accompanying operating and technical procedures.
• 2+ years of experience in developing and presenting information and recommendations aimed at Senior Leadership.

Bonus Points

• Bachelor's degree in Engineering, Business Administration, or other related field.
• Lean Six Sigma Green Belt certification or higher.
• 2+ years of experience with process improvement methodologies such as Lean, Six Sigma and/or Theory of constraints.
• ACA marketplace, provider network, claims, healthcare quality, or provider data 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.