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Program Lead, Payor Connections/Interoperability

Remote

Hi, we're Oscar. We're hiring a Program Lead, Payor Connections/Interoperability to join our Risk Adjustment team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless 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:

As a Program Lead, Payor Connections/Interoperability, you will be a key owner of an important interoperability initiative, the Program Lead will represent the needs and interests of the Risk Adjustment team. This new role is for you if you thrive with ambiguity and autonomy, and are comfortable building an end-to-end process! You will work with internal and external Oscar partners to ensure accurate acquisition of healthcare data from multiple provider systems.

You will report into the Director, Risk Adjustment Retrospective.

Work Location: This is a remote position, open to candidates who reside in: Arizona, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Virginia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

Pay Transparency: The base pay for this role in the states of New Jersey and New York is: $101,844 - $133,670 per year.  The base pay for this role in all other locations is: $91,659 - $120,303 per year.  You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

  • Lead interoperability projects with provider outreach
  • Develop relationships with provider group partners and vendors
  • Create and maintain project plans
  • Help develop operational strategy and market approach
  • Collaborate across the organization to identify actions to achieve improvements and monitor initiative impact
  • Direct the testing and validation of data connections to ensure compliance and functionality
  • Oversee the creation and maintenance of essential operational dashboards, and update and enhance them as our user's needs evolve
  • Track development progress, resolve issues related to data quality or integration, and ensure continuous improvement in interoperability programs
  • TEFCA subject matter expert
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • 3+ years of work experience in health care operations or health insurance; working directly with provider groups
  • 2+ years of experience in delivering interoperability projects / programs
  • In depth knowledge of TEFCA
  • Strong analytical skills

Bonus points:

  • Risk Adjustment experience
  • Basic SQL or BQ query writing experience

This is an authentic Oscar Health job opportunity.

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.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

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 Privacy Policy.

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The work location expectations for this role is listed in the job postings under “Work Location”. This section includes any onsite related expectations and residency requirements.

Oscar Health is authorized to do business in many, but not all, states. If you are not located in or willing to relocate to a state where Oscar is registered, you will not be eligible for employment. The approved states for this role are listed in the job posting.

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As set forth in Oscar Health’s Equal Employment Opportunity policy, we do not discriminate on the basis of any protected group status under any applicable law.

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