Associate, Quality Improvement Operations

Job Description

Hi, we're Oscar. We’re hiring a Quality Improvement Operations Associate to join our Quality Operations team in our New York office.

Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, transparent, and human. We need your help to do so.

About the role:

This role will work on NCQA accreditation and delegated quality activities on behalf of Oscar’s national corporation. This person will act as a subject matter expert in NCQA Utilization Management, Credentialing and Network Management Standards. You will report into the

Manager, Quality Improvement

Responsibilities:

• Responsible for project management of corporate NCQA activities for UM, CR, and any additional national accreditations.
• Act as a subject matter expertise and provide education on NCQA standards related to UM, CR, and PN.
• Ensure consistency of accreditation standards interpretation and process implementation.
• Review and approve documents, including policies, to ensure they meet NCQA requirements.
• Upload completed documents to the NCQA IRT tool.
• Ensure the IRT tool accurately reflects submission of standards and documents.
• Manage Mulberry Management Corporation (MMC) documentation needs related to its sister organization relationships and the Cigna partnership.
• Coordinate and oversee reporting, adherence needs, and quality improvement activities that support our strategic partnerships.
• Ensure that other standards are followed in these areas as needed by partnership agreements.
• Maintain knowledge of industry trends and practices.

Requirements:

• 3+ years of healthcare related experience in project management, quality improvement/management, managed care or population health.
• 2+ years of experience spent directly working on NCQA UM/CR Accreditation.
• Associate’s degree or equivalent work experience required
• You have worked with quality improvement methodologies, research, and data analysis
• You have experience interacting with internal and external stakeholders.
• You are a collaborator and can follow a project plan while driving cross-functional teams to execute against considering competing priorities and viewpoints.

Bonus points:

• Knowledge of industry best practices and regulatory compliant reporting.
• Management experience with URAC standards.
• Familiarity with other NCQA accreditation programs (ie. Provider Network, Multicultural Health Care, Population Health Program, Case Management, MBHO, etc.)

Life at Oscar:

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

We encourage our members to care for their whole selves, and we encourage our employees to do the same with comprehensive medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, and volunteer opportunities.

Reasonable Accommodation:

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 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 .