Medicare Advantage, Operations Associate

Job Description

Hi, we're Oscar. We’re hiring an Operations Associate to join our Medicare Advantage team in our Tempe 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 plays an essential role in operating our Medicare Advantage (MA) business. Responsible for providing subject matter expertise to service and operations teams, promote infusion of MA knowledge into operations teams supporting the product line, develop and maintain training and resource materials for operations teams and identifying opportunities to support the ongoing effort to achieve operational excellence in our MA operations

You will report into the Sr. Director, Medicare Advantage.

Responsibilities:

• Support efforts to achieve operational excellence in our Medicare Advantage product.
• Partnering with the Learning and Development team support the development, maintenance, and delivery of MA training programs and materials for operations teams, including (but not limited to): Customer Service, Provider Service, Enrollment, and Claims
• Be responsible for maintenance of the repository of resource materials used by the MA Customer Service team on a day-to-day basis, including routine review of existing content and development of new or revised content to facilitate optimal call handling and resolution.
• Serve as an MA subject matter expert and day-to-day escalation point for service teams and operations units.
• Perform routine monitoring of Customer Service and Provider Service calls to identify opportunities for improvement. Coordinate the process improvement initiatives needed to address those opportunities.
• Perform routine monitoring of MA-related processes, including enrollment file handling and claims processing. Identify opportunities to improve adherence to regulatory requirements and optimize efficiencies. Drive corrective actions needed to address those opportunities.
• Partner with MA operations teams to execute on Star Ratings-related initiatives.
• Support program to identify and mitigate root causes leading to CTMs and grievances.

Requirements:

• Bachelor’s Degree or 6 years working for an MA plan in an operations or compliance role
• 3+ years of work experience in a Medicare Advantage (MA) plan working in an operations or compliance role

Bonus points:

• Ability to identify problems and initiate corrective actions and preventive actions utilizing various quality tools.
• Self-motivated, and focused on continuous improvement with the ability to work independently and/or on a team with minimal supervision

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 .