Oscar Health - Senior Specialist, Process improvement (SIU)
Requirements
• A Bachelor's degree or 4+ years of commensurate experience • 2+ years experience in a technical role (QA analyst, PM, operations analyst, finance, consulting, industrial engineering) or a process improvement role (Six Sigma or similar) • 2+ years of experience working with large data sets using excel or a database language • 1+ years experience deriving business insights from datasets and solving problems • 1+ years experience improving business workflows and processes • 1+ years experience collaborating with internal and/or external stakeholders • An academic and/or professional background in engineering, data, or healthcare • Experience in a professional healthcare claims organization • Experience working in or with an SIU • Knowledge management, training, or content development in operational settings • Process Improvement or Lean Six Sigma training aids • Experience using SQL • This is an authentic Oscar Health job opportunity.
Responsibilities
• Work Location: This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote • Work Location: • excluding • Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $75,348 - $98,894 per year. The base pay for this role in all other locations is: $67,813 - $89,005 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. • Pay Transparency: • SIU Operations & Incident Response: Conduct Special Investigations Unit (SIU) intake, triage, and tip research. Support operational goals by providing rapid root cause analysis and training for escalated issues. • Risk Mitigation & Problem Resolution: Identify operational risks in coordination with leadership, investigating and resolving issues to inform short-, medium-, and long-term technology-driven solutions. • Stakeholder Feedback & Solutions: Scope, prioritize, and deliver effective solutions based on internal and external partner feedback regarding adverse claim outcomes. • Data Analysis & Technical Requirements: Use data analysis tools to produce quantitative insights, translating findings into detailed technical business requirements for cross-functional partners. • Proactive Improvement: Leverage insights from partner submissions, data mining, and process monitoring to identify and address systemic areas of opportunity. • Operational Organization: Maintain accurate records in accordance with the organization's retention policies, ensuring files are securely stored and accessible. Support consistent team organization through clear documentation, standardized filing practices, and routine upkeep of the shared systems. • Project & Process Management: Coordinate key projects to meet service level agreements and milestones, supporting financial discipline, quality, and continuous improvement. • Cost Optimization & Compliance: Partner with leadership and cross-functional teams to implement initiatives aimed at reducing overall costs, enhancing outcomes, and ensuring compliant business operations. • Stakeholder Communication: Maintain transparency by keeping key stakeholders informed of project progress, status updates, and blockers. • Compliance with all applicable laws and regulations • Other duties as assigned
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