Remote Jobs at Oscar Health

Posted 2024-11-20

📍 Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington, D.C.

🧭 Full-Time

💸 131200 - 172200 USD per year

🔍 Health insurance

PharmD degree.
Active, unrestricted pharmacist license.
4+ years of experience with UM reviews.
4+ years of experience with clinical research, policy development, and/or medical writing.
3+ years of experience in Excel.
Bonus: Experience with CVS portal, fast-paced collaborative environments, residency training completed from accredited ASHP or AMCP programs.

Be accountable for the end-to-end process for development and review of pharmacy and medical drug guidelines.
Lead a team of contracted and/or matrixed reports to ensure timely review and submission of guideline updates.
Draft, obtain approval, and maintain pharmaceutical and medical drug policies based on clinical evidence.
Manage direct, contracted, and matrixed team members.
Ensure processes and policies adhere to departmental strategy.
Prepare and present materials for executive review, summarizing changes and tracking advancements.
Conduct high-complexity reviews requiring extensive industry expertise.
Partner with vendors for pharmacy code edit accuracy in claims systems.
Maintain subject matter expertise on pharmaceutical trends and evidentiary standards.
Comply with State, Federal, and NCQA requirements and provide support for regulatory audits.

LeadershipMicrosoft ExcelAttention to detailOrganizational skillsPresentation skillsTime ManagementWritten communication

Posted 2024-11-20

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🔥 Senior Sales Executive

Posted 2024-11-13

📍 Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington, D.C.

🧭 Full-Time

💸 88800 - 111000 USD per year

🔍 Health insurance

4+ years of experience in the healthcare industry in an outside sales role.
3+ years of experience presenting and communicating with stakeholders at all levels.
Must possess a valid insurance license.
Bachelor's Degree or 4 years of relevant experience preferred.
Proficient in Salesforce.
Bilingual (Spanish speaking) is a bonus.

Building and managing broker and GA (General Agent) relationships in the assigned geographic market.
Identifying distribution partners and building relationships to support growth goals.
Training brokers and GA partners on Oscar's product.
Representing the product at local broker and community events, including evenings/weekends.
Identifying and testing new growth opportunities and sharing findings with the sales team.
Collaborating with teams to enhance product tools and processes.
Meeting or exceeding sales goals while servicing distribution partners.
Providing local competitive intelligence and market research.
Acting as the voice of brokers and consumers within the product.

LeadershipBusiness DevelopmentProduct ManagementCross-functional Team LeadershipBusiness developmentGoCommunication SkillsAnalytical SkillsCollaborationProblem SolvingNegotiationAttention to detailOrganizational skillsPresentation skillsTime ManagementWritten communication

Posted 2024-11-13

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🔥 Senior Counsel

Posted 2024-11-13

📍 Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington D.C.

🧭 Full-Time

💸 172200 - 252000 USD per year

🔍 Health insurance

Attorney in good standing with J.D. from an ABA accredited law school.
At least 8 years of relevant experience at a top tier law firm and/or in-house.
Experience working in the health insurance industry for at least 7 years, understanding payer-provider disputes.
Experience managing a complex litigation portfolio in-house for at least 7 years.
Experience litigating a variety of complex disputes on both plaintiff and defendant sides for at least 7 years.
Understanding of end-to-end litigation processes, legal research, eDiscovery, and contract drafting and interpretation.
Litigation experience in Florida, California, Texas, and/or New York jurisdictions.

Work with important partners on a cohesive and comprehensive litigation strategy that aligns with our strategic goals.
Build our litigation strategy and ensure that a variety of complex litigation matters are managed.
Engage to ensure we have the processes and operations to respond to and defend against litigation matters and to minimize litigation in the future.
Develop a budget for assigned litigation matters and manage outside counsel.
Develop metrics which demonstrate trends on the organizations’ litigation portfolio.
Provide strategic and guidance on state legal and regulatory requirements applicable to health insurers and HMOs.
Ensure compliance with applicable laws and regulations.

LeadershipGoCommunication SkillsAnalytical SkillsCollaborationProblem SolvingMentoringNegotiationAttention to detailOrganizational skillsPresentation skillsTime ManagementWritten communicationDocumentation

Posted 2024-11-13

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🔥 Senior Quality Data Analyst, Claims

Posted 2024-11-13

📍 Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington, D.C.

🧭 Full-Time

💸 84000 - 122850 USD per year

🔍 Health Insurance

4+ years of experience within claims operations.
3+ years professional experience debugging and solving complex data problems.
2+ years of experience utilizing strong SQL skills.
2+ years of experience with data management principles and data quality assurance.
2+ years of experience designing and/or improving data models.
2+ years of experience presenting and delivering messages to senior leadership.
Expert in Excel and/or Google Sheets with 3+ years of experience.

Collaborate with cross-functional teams to identify healthcare data-related challenges and develop comprehensive solutions.
Produce required data deliverables and provide technical & analytical support for Oscar’s Operations.
Develop and implement healthcare data management strategies to ensure ongoing data integrity and accuracy.
Create custom queries to facilitate ad-hoc requests and utilize data to validate assumptions.
Monitor and evaluate data management systems and processes to ensure compliance with regulations and industry standards.

LeadershipSQLOperations ManagementCompliance

Posted 2024-11-13

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🔥 Senior Director, Strategic Finance & Corporate Development

Posted 2024-11-13

📍 Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington, D.C.

🧭 Full-Time

💸 172800 - 252000 USD per year

🔍 Healthcare

12+ years in analytical financial roles, with at least 5 years in a public company.
8+ years of financial modeling experience to translate data into actionable insights.
5+ years of corporate development experience.
5+ years of experience collaborating at the executive level.

Develop and track multi-year enterprise-wide Operating Plan and monitor progress against key metrics.
Drive corporate development initiatives including mergers & acquisitions.
Lead financial and capital modeling efforts for strategic decision-making.
Evaluate strategic growth initiatives in collaboration with the Corporate Strategy team.
Support capital market activities and Treasury team.
Develop and manage a high-performing Strategic Finance & Corporate Development team.
Collaborate with executive business line owners and Finance Leadership.

LeadershipStrategyFinancial ManagementCollaborationCompliance

Posted 2024-11-13

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🔥 IT Internal Audit Associate Director

Posted 2024-11-12

📍 United States

🧭 Full-Time

💸 142560 - 207900 USD per year

🔍 Health Insurance

Bachelor's degree in Information Systems, Computer Science, or a related field.
7+ years of experience in IT audit, risk management, or information security, or a similar role.
4+ years of experience in a Platform as a service company.
4+ years of experience managing a team of internal or co-sourced consulting resources.

Lead the IA effort in performing risk assessments to identify technology risks and develop a risk-based IA plan for IT integrated internal audits.
Develop and execute an internal audit plan for the Technology business in partnership with the Internal Audit team.
Provide insights into areas such as information security, cyber security, data privacy, and technology risk management.
Collaborate with other corporate risk and control functions to ensure coordinated activities.
Assist in the development of board reporting to the Audit Committee.
Present findings and recommendations to management, articulating risks and implications.
Develop and maintain relationships with business line management.

LeadershipCybersecurityPeople ManagementCross-functional Team LeadershipCommunication SkillsAnalytical SkillsCollaborationProblem SolvingAttention to detailOrganizational skillsPresentation skillsTime ManagementWritten communication

Posted 2024-11-12

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🔥 Program Associate, Complex Issue Resolution

Posted 2024-11-09

📍 Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington, D.C.

🧭 Full-Time

💸 84240 - 122850 USD per year

🔍 Health Insurance

3+ years in program and project management
3+ years in change management and process improvement
3+ years stakeholder management experience
Healthcare claims experience

Organize and support daily activities based on the goals of the claims issue resolution program
Identify optimization opportunities to support program objectives
Support implementations end to end to ensure success
Lead certain components of the program
Partner with other departments and various stakeholders to ensure operational excellence
Assist in project plan development and keep stakeholders informed on status
Track and resolve program risks and milestones
Support the tracking and monitoring of controls
Develop tools and standards for ongoing team programs
Create meeting materials, track action items, and manage project plans
Ensure compliance with applicable laws and regulations

LeadershipProject ManagementData AnalysisPeople ManagementProject CoordinationJiraCross-functional Team LeadershipData analysisCommunication SkillsAnalytical SkillsCollaboration

Posted 2024-11-09

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🔥 Utilization Management Liaison Lead

Posted 2024-11-07

📍 Alabama, Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, D.C.

🧭 Full-Time

💸 48960 - 64260 USD per year

🔍 Health insurance

2+ years experience in a customer service environment.
1+ year of direct people management experience.
1+ years of experience using data and metrics to guide improvements.
1+ years of experience working with teams in multiple locations and disciplines.

Hire and manage a team with responsibility for performance management and HR tasks.
Monitor outcomes, track operational KPIs, and conduct root-cause analysis.
Understand daily team operations for effective decision-making.
Lead team meetings to align with Oscar’s mission and encourage goal achievement.
Promote an inclusive team culture aligned with Oscar’s values.
Engage in continuous improvement activities for the production team.
Identify and close operational workflow gaps.
Collaborate with other teams to implement best practices.

LeadershipPeople ManagementCustomer serviceMicrosoft OfficeComplianceCoaching

Posted 2024-11-07

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🔥 Team Lead, Service Operations Quality Assurance

Posted 2024-11-07

📍 Alabama, Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, D.C.

🧭 Full-Time

💸 48960 - 73440 USD per year

🔍 Health Insurance

3+ years experience in production and/or service operation.
3+ years experience in a quality-focused role.
2+ years experience in a health insurance or healthcare organization.
1+ year direct people management experience in a production environment.
1+ years experience using data and metrics for improvements.
Familiarity with industry regulations and standards.

Hire and manage a team, overseeing performance and HR tasks.
Monitor and analyze team outcomes and operational KPIs.
Lead team meetings and encourage alignment with the company’s mission.
Foster an inclusive and engaging team culture.
Identify workflow gaps and collaborate for improvements.
Ensure compliance with laws and other relevant duties.

LeadershipPeople ManagementMicrosoft OfficeComplianceCoaching

Posted 2024-11-07

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🔥 Team Lead, Claims Production

Posted 2024-11-07

📍 Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington, D.C.

🧭 Full-Time

💸 51120 - 74550 USD per year

🔍 Health Insurance

3+ years of direct experience leading and supporting a claims operations area.
3+ years of medical claims processing experience.
2+ years reading and using claims data to identify trends.
Bonus points for prior health plan experience, claims payment processes, and proficiency in Google Office Suite, Excel, JIRA, and SQL.

Guide your team’s metrics, including member and provider satisfaction, quality of care, and employee satisfaction.
Coach direct reports through a culture of feedback and development to provide the best experiences.
Serve as a central communicator, leading team huddles and promoting company values.
Manage the daily needs of your team, including hiring, training, inventory, and scheduling.
Ensure compliance with all applicable laws and regulations.

LeadershipSQLData AnalysisPeople ManagementJiraCross-functional Team LeadershipOperations ManagementData analysisCommunication SkillsCollaborationMicrosoft ExcelProblem SolvingMicrosoft OfficeAttention to detailOrganizational skillsTime ManagementWritten communicationMicrosoft Office SuiteCoaching

Posted 2024-11-07

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