Utilization Review Processor

Summary

Join Oscar's Utilization Review team as a Utilization Review Processor! You will resolve complex issues impacting providers and members, communicating with providers and collaborating with internal teams for efficient resolutions. You'll manage your workload effectively, setting timely outreaches and communicating roadblocks. This role requires 1+ years of customer support experience and involves working with internal tools and resources. The position offers a blended work culture with remote options and a competitive hourly rate of $19.00, plus benefits including medical, dental, vision, paid time off, 401(k), life and disability insurance, and more. You must reside in one of the specified states and be available to work at least two days a week in the office if within commuting distance of an Oscar office.

Requirements

1+ years of customer support/service experience

Responsibilities

• Manage queue work and and assigned caseload through efficient dashboard management
• Identify, investigate, and resolve issues within determined SLAs
• Collaborate with colleagues, Specialists, Experts, and Leads to identify trends and roadblocks
• Use internal tools and resources seamlessly
• Communicate findings and resolutions with providers and internal departments
• Compliance with all applicable laws and regulations
• Other duties as assigned

Preferred Qualifications

• Advanced computer literacy skills with experience using CRM and knowledge management tools to resolve client issues
• Experience using ticket management and reporting tools
• Experience managing an assignment caseload
• Customer service experience
• Healthcare and/or SAAS 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
• Monthly vacation accrual at a rate of 10 days per year