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Senior Analyst, Utilization Management Design & Configuration

81% Flex
EXTRA HOLIDAYS - EXTRA PARENTAL LEAVE - FULLY FLEXIBLE
Remote: 
Full Remote
Contract: 
Salary: 
69 - 101K yearly
Experience: 
Junior (1-2 years)
Work from: 

Offer summary

Qualifications:

1+ year working knowledge of health plan benefit concepts, 1+ year Proficient in Microsoft Word, Excel, and PowerPoint or comparable programs.

Key responsabilities:

  • Analyze and summarize process behavior for design/solutioning
  • Translate configurations to resolve internal team escalations
  • Process Jira tickets for member escalation support
  • Write first-draft requirements for legal updates
  • Identify opportunities to improve operational efficiency, manage workflows
Oscar Health logo
Oscar Health Insurance Large https://www.hioscar.com/
1001 - 5000 Employees
See more Oscar Health offers

Job description

Logo Jobgether

Your missions

Hi, we're Oscar. We're hiring a Senior Analyst to join our Utilization Management Design & Configuration team.

Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

The Senior Analyst, Configuration supports the business by improving the consistency, accuracy, and efficiency of platforms, systems and processes. Through understanding of the platform configuration capabilities, this role helps ensure that processes are configured accurately.

You will report to the Senior Manager UM Design & Confirguration.

Work Location:

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.

If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.

You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, 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. Note, this list of states is subject to change. #LI-Remote

Pay Transparency:

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $76,800 - $100,800 per year. The base pay for this role in all other locations is: $69,120 - $90,720 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities
  • Analyze and summarize process behavior to expedite the design/solutioning process
  • Translate configuration helping internal teams resolve escalations 
  • Process incoming Jira tickets to support member escalation resolution
  • Write first-draft requirements for ad-hoc legal updates 
  • Identify and pilot opportunities to improve operational efficiency  
  • Assess and manage workflows of ingested items 
  • Investigate escalations via incoming tickets or informal pathways
  • Conduct necessary maintenance work and take on ad-hoc projects associated with benefits configuration. 
  • Compliance with all applicable laws and regulations
  • Other duties as assigned
Qualifications
  • 1+ year working knowledge of health plan benefit concepts (e.g., deductibles, copays and other forms of cost sharing, etc.).
  • 1+ year Proficient in Microsoft Word, Excel and PowerPoint and/or comparable programs within the Google Docs Editors suite
Bonus Points
  • Experience working in health insurance industry/claims
  • SQL proficiency 
  • Experience working with Jira

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here

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.

Pay Transparency:  Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

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.

California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Notice to Job Applicants.

Required profile

Experience

Level of experience: Junior (1-2 years)
Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Soft Skills

  • verbal-communication-skills
  • Relationship Building