Senior Operations Analyst- Delegate Oversight

Job Description

Hi, we’re Oscar.

At Oscar, we are working hard to provide the kind of health insurance we would want for ourselves. This means that we get to be creative and to build an excellent insurance operation from the ground up.

As an Operations Analyst with a focus on delegate oversight on the Clinical Review team at Oscar, you will take ownership of aspects of our utilization management operational processes and identify areas for potential improvement. You will drive the development of process improvements and facilitate cross-functional support where needed. In addition, you will play a large role in troubleshooting issues that arise by investigating the scope, cause and scale of the problem throughout our clinical review operation.

You will also be responsible for driving the performance and compliance of Oscar’s delegated accounts - third party organizations to which Oscar delegates core insurance functions - and building out Oscar’s delegate oversight program as the company grows for the Clinical Review team. The role will combine support for Oscar’s cross-functional Delegation Oversight Committee (DOC) with project management and operational process improvement of DOC activities including delegate contracting, reporting and auditing for utilization management.

Note that this position has the potential for tremendous growth and leadership opportunities as the organization scales and expands into new markets. We are looking for people who are excited to grow with us.

Deliverables: What you have to achieve

During Your First Six Weeks

You have...

• Built a deep understanding of our operational policies and workflows
• Developed some initial insights into opportunities for workflow improvements
• Become well-acquainted with internal tools, data, and technical processes (e.g. database querying)
• Begun to form a strong working relationship across the Oscar team and with our delegate partners
• Developed a comprehensive understanding of our performance metrics
• Gained an informed view of Oscar’s core delegate relationships and oversight program
• Developed an understanding of Oscar’s operations and relationships with your counterparts on key internal teams such as compliance, quality, claims, care delivery and customer service
• Begun to drive oversight activities for Oscar’s delegated accounts

Afterwards And On An Ongoing Basis

You will...

• Surface data, process, and technology issues through proactive identification, measurement, and monitoring of our operations
• Improve existing workflows and work with and find automation opportunities
• Support your team and leadership by driving decisions and implementation on an ongoing basis
• Identify areas for policy clarification and stay up to date on operational policies
• Assist in creating documentation of workflows, SOPs and policies
• Manage and maintain relationships with relevant stakeholders as a representative of clinical review operations
• Become the go-to individual at the company for utilization management delegate oversight operations and compliance
• Interface regularly with Oscar business leads to drive discussions related to delegate oversight, ensure deliverables are completed on time and remove roadblocks
• Participate in and support quarterly Delegation Oversight Committee (DOC) meetings with Oscar business leads
• Continually refine operational processes for delegate oversight to ensure compliance and scalability

Winning factors: What leads to success

Must-have Qualifications And Expertise Include

• A bachelor’s degree
• 1-3 years of professional experience
• Excellent problem-solving skills
• Strong critical thinking and analytical capabilities
• High attention to detail
• Have a process improvement bend and the aptitude to quickly learn Oscar’s ecosystem
• Strong verbal and written communications
• Ability to explain complex processes and ideas using simple and friendly language
• Experience overseeing large projects that require strong organizational skills

We think it will make a big (positive) difference if you have...

• Experience in an operational rotational program
• Excellent relationship building and account management abilities
• Previous experience in a highly collaborative, team-based environment
• Experience in SQL or similar database languages
• Enjoy leveraging technology in creative/novel ways to solve problems
• Proficiency in Microsoft Office Suite
• Demonstrated process improvement qualifications/certifications
• Capabilities in organizing, prioritizing, and managing complex processes and projects

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we work to cultivate an environment where exceptional people can be their most authentic selves and find both belonging and support. We're on a mission to change healthcare -- an experience made whole by your unique background and perspectives.

Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([email protected]) to make the need for an accommodation known.

Pay Transparency Policy: Oscar's Pay Transparency Policy ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here .