Director, Provider Operations
- New York, NY
Hi, we're Oscar. We’re hiring a Director to join our Insurance Operations team in our New York City 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 this role:
Great health insurance starts with a great network. We partner with providers and outstanding health systems to change healthcare for the better. As an Associate Director on Insurance Operations, you will build and optimize processes in the Provider Lifecycle to ensure Oscar’s provider networks are adequately serving our members’ healthcare needs. You will review end-to-end processes that support expansion goals, maintaining adequacy of our networks, managing underlying Provider data, and ensuring members have access to the care they need . You will also ensure all parties understand their role in operationalizing these processes. Your work will have a direct impact on Oscar’s ability to provide a great member experience.
You will report into the Senior Director of Operations.
Responsibilities:
- Design and improve the end-to-end process for Oscar’s expansion into new markets including identifying markets, executing contracting, and on-boarding new providers
- Design and improve the end-to-end process for how Oscar ensures regulatory and member experience adequacy is being met by filling gaps when they arise
- Improve an end to end Single Case Agreement (SCA) process to improve compliance, member and provider experience, and clinical and MLR outcomes.
- Identify and project manage Network/Provider projects including Open Enrollment preparation
- Work with leaders across the organization to ensure successful implementation of the projects
- Improve the quality of our provider data and set up monitoring and metrics to accurately track our network
Requirements:
- Bachelor's degree or equivalent work experience
- 10+ years experience in a Healthcare provider/payer operations environment
- Experience in process / workflow building, operational improvement, and project management
- Experience working cross functionally and communicating with peers at all levels
- Ability to build models to answer your own questions, to form data-driven, concrete answers in a world with imperfect information
- Experience managing a team
Bonus points:
- Experience working with product, engineering and data teams to create and improve processes
- Experience in management consulting, strategy, or investment banking
- Python and SQL
- Experience or qualifications in Lean methodology
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 (accommodations@hioscar.com) 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.
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