Manager, Complex Claims

Posted 1 day agoViewed

💎 Seniority level: Manager, 4+ years

📍 Location: Alabama, Arizona, Arkansas, 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, or Washington, D.C.

💸 Salary: 92880.0 - 129000.0 USD per year

🔍 Industry: Health Insurance

🏢 Company: Oscar Health👥 1001-5000💰 $140,000,000 Private over 4 years ago🫂 Last layoff about 5 years agoHealth Insurance InsurTech Insurance Health Care

🗣️ Languages: English

⏳ Experience: 4+ years

🪄 Skills: LeadershipProject ManagementData AnalysisPeople ManagementProcess improvement

Requirements:

4+ years leading, coaching and developing direct reports in a claims environment
4+ years of experience analyzing data to solve complex claims problems
2+ years experience designing, implementing and improving business workflows

Responsibilities:

Be the subject matter expert for Claims operations through knowledge and expertise of Oscar’s claim platform, claim regulatory requirements and operational workflows
Manage a complex portfolio of initiatives and deliverables and proactively identify areas of opportunity to improve key performance indicators
Develop team workflows and guidelines that produce consistent and measurable outcomes; train, teach and mentor team members to become more proficient and effective.
Lead teams for the review of highly specialized claims processing including: high cost claims, transplants, COB and other third-party insurance
Conducting detailed information gathering, analysis and investigation to find solutions, and reporting to senior leaders on complex claims trends and developments
Compliance with all applicable laws and regulations
Other duties as assigned

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