CGA Team Lead

New

OscarHealth insurance

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas.Full-TimeLead

Salary55,890 - 73,355 USD per year

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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

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 of, Google Docs and Sheets.
State-level audit experience, management or leadership experience, and a bachelor's degree are bonus qualifications.

Manage day-to-day team operations to ensure cases meet federal and state regulatory requirements and timeframes.
Apply critical thinking to establish workflows that meet internal and external SLAs and turnaround times.
Coach direct reports and provide feedback, recognition, and performance support.
Monitor team performance and case processing for accuracy and timeliness, including complaints, grievances, and appeals.
Identify training needs and team trends, and coordinate process improvements.
Review case management dashboards and error reports to monitor productivity, accuracy, and timeliness.
Manage inventory and distribute work to meet production standards and turnaround times.
Coordinate with other business units and answer internal and external customer questions about CGA processes.
Recommend and help lead process improvements.

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