Remote Senior Claims Expert
at Oscar

Summary

Join Oscar's Operations team as a Vice President, Senior Claims Expert and provide decision-making and advisory support to the Claims & Benefits team.

Requirements

• 15+ years experience in a claims role
• Extensive knowledge of and experience in implementing Claims regulations, payment methodologies and policies
• 5+ years of experience in healthcare operations with an emphasis on designing and reengineering healthcare operational processes
• 5+ years experience in process / workflow building, systems design / configuration, or operational improvement
• 5+ years people management

Responsibilities

• Provide detailed guidance on Claims & Benefits topics (including implementation of regulations, system logic and configuration, payment methodologies, policies, etc.) based on industry standards and best practices
• Participate and present the claims industry point of view in internal and external discussions
• Drive decision-making process on key strategic initiatives and complex business issues
• Work closely with leaders within Claims & Benefits and across the organization on new policies and strategic initiatives
• Guide implementation of regulatory and business requirements into workflows and processes
• Guide implementation and monitoring of key controls
• Compliance with all applicable laws and regulations
• Other duties as assigned

Benefits

• Full-time employees are eligible for benefits including: 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