Associate, Inquiries and Investigations
About the role
About the role
Work Location
Pay Transparency
Responsibilities
- Leads the end-to-end management of cross-functional implementations and projects-including project plan creation, stakeholder engagement, edge case mitigation, and on-time completion-to enhance processes and execute data corrections that directly impact directory accuracy and filing submissions.
- Evaluates departmental performance by creating, gathering, analyzing, and interpreting data to inform technology-enabled solutions, establish departmental key metrics, and implement mitigation strategies that ensure quality and financial discipline
- Collaboratively works with leadership, peers, and internal/external stakeholders to investigate risks and escalations, formulate proactive strategies, and partner across teams on continuous improvement action plans through final release to production
- Mentors team members and promotes colleagues' professional growth, fostering team collaboration and driving mindset shifts necessary to optimize operational efficiency and achieve departmental targets
- Compliance with all applicable laws and regulations
- Other duties as assigned
Requirements
- A bachelor's degree or 3+ years commensurate experience
- 3+ years of professional experience in payer or provider healthcare contracting, provider network management, healthcare operations, or a related field
- 2+ years of experience using data software such as Excel, SQL or other data analytics tools
- 2+ years of experience with end to end project management
- 2+ years of experience in designing and improving workflows as well as standing up accompanying operating and technical procedures
- 2+ years of experience in developing and presenting information and recommendations aimed at Senior Leadership
Bonus points
- Bachelor's degree in Engineering, Business Administration, or other related field
- Lean Six Sigma Green Belt certification or higher
- 2+ years of experience with process improvement methodologies such as Lean, Six Sigma and/or Theory of constraints
- ACA marketplace, provider network, claims, healthcare quality, or provider data experience
This is an authentic Oscar Health job opportunity.
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.
Pay Transparency
Artificial Intelligence (AI)
Reasonable Accommodation
California Residents
Not included in the source posting: about the role, benefits.
Skills
Who can apply
The employer didn't state any visa, work authorization, citizenship or clearance requirements in this posting. Confirm with the employer before applying.
Read automatically from the employer's posting text. Always confirm with the employer — requirements can change after a job is published.