Operations Associate, Claim Design & Configuration

Summary

Join Oscar's Claims Design team as an Operations Associate, Claim Design & Configuration! This role focuses on designing, optimizing, and implementing processes to improve Oscar's claims adjudication platform. You will leverage technology and automation to enhance efficiency and scale. The position requires strong analytical skills, experience with data software (SQL or Python), and a proven ability to design and improve workflows. You'll collaborate cross-functionally, identify risks, and develop solutions. This is a blended work culture with remote options available, and competitive compensation and benefits are offered.

Requirements

• Possess a bachelor’s degree or 4+ years of commensurate experience
• Have 3+ years of experience in operations, health insurance, data analysis, engineering and/or consulting
• Have 3+ years of experience using data software such as SQL or Python
• Have 3+ years of experience in analytics & the ability to derive insights from complex, broad datasets
• Have 1+ years of experience designing and improving workflows as well as standing up accompanying operating and technical procedures

Responsibilities

• Design and prioritize operational processes by working cross-functionally to gather business requirements and implementing process and technology-enabled solutions
• Lead and cross-collaborate on iterative problem definition and technical design and scoping to build solutions with the end-user in mind
• Utilize and analyze data to independently drive business decisions, impact cross-functional strategy and develop KPIs to measure the effectiveness of your domain
• Proactively identify risks; respond to and resolve issues/errors/escalations through data-driven investigation to produce insights for short, medium, and long-term technology-enabled solutions
• Distill the requirements of new product and design automated workflows to reduce manual work requirements
• Work with other team members to resolve issues, develop training, and create technical tooling to enable others
• Comply with all applicable laws and regulations
• Perform other duties as assigned

Preferred Qualifications

• Have Process Improvement or Lean Six Sigma training
• Have experience with healthcare claims processing

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
• Annual performance bonuses
• Unlimited vacation program