CGA Team Lead
New
O
OscarHealth insurance
This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas.Full-TimeLead
SalaryThe base pay for this role is: $55,890- $73,355 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.
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Job Details
- Experience
- 3+ years of relevant experience directly related to this role; 2+ years experience with and equivalent knowledge of Commercial Insurance, Medicare/Medicaid and/or Affordable Care Act rules and regulations relating to the Grievance & Appeals processes; 1+ years experience with or relevant knowledge of navigating Google Docs and Sheets.
- Required Skills
- Google Sheets
Requirements
- Have 3+ years of relevant experience directly related to the role.
- Have 2+ years of experience with or equivalent knowledge of Commercial Insurance, Medicare/Medicaid, and/or Affordable Care Act rules and regulations relating to grievance and appeals processes.
- Have 1+ year of experience with or relevant knowledge navigating Google Docs and Sheets.
- Bonus: Experience with a state-level audit.
- Bonus: Management or leadership experience.
- Bonus: Bachelor's degree.
Responsibilities
- Manage day-to-day CGA team operations to ensure compliance with federal and state regulations and timeframes across case types and lines of business.
- Apply critical thinking to establish workflows that meet internal and external SLAs and TATs.
- Coach, provide feedback to, and recognize direct reports; support corrective action procedures with manager and HR oversight when needed.
- Use knowledge of state and federal regulations to ensure case and deliverable accuracy.
- Monitor direct-report performance, including case processing, attendance, schedules, and other job-related behavior.
- Identify team training needs from individual performance and team trends, and coordinate training and process improvements.
- Track team metrics and compliance, and review case-management dashboards and error reports for productivity, accuracy, and timeliness.
- Manage inventory and distribute work to meet production standards and turnaround times.
- Answer internal and external customer questions, assist peers and managers, and liaise with other business units on CGA processes.
- Serve as a subject matter expert and recommend and help lead process improvements.
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