Job description
Hi, we’re Oscar. We’re hiring a Director, Claims and Benefits Configuration to join our Claims 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
As Director of Claims and Benefits Configuration, you will lead a team responsible for managing plan and benefit configuration across the organization. Your key responsibilities include developing and leading execution of the plan and benefit configuration roadmap and collaborating with Insurance Product and Technology teams, as well as the broader Insurance Operations organization, to perform ongoing configuration activities and build scalable solutions to improve the configuration space.
You will report to the Senior Director, Claims Design & Benefits
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 be expected to 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, 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. 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: $174,400 - $228,900 per year. The base pay for this role in all other locations is: $156,960 - $206,010 per year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program, company equity grants and annual performance bonuses.
Responsibilities
- Lead, coach and develop a high-performing team
- Creates team strategy and participates in setting department level strategy
- Owns and prioritizes Configuration operations roadmaps working cross functionally to gather business requirements in order to implement and improve the efficacy and efficiency of existing operational processes or to unlock new platform capabilities
- Oversee the utilization of data to independently drive business decisions, drive cross-functional strategy and develop KPIs to measure the effectiveness of your domain
- Proactively identify and review risks; oversee responses to and resolutions to issues/errors/escalations through data-driven investigation to produce insights for short, medium, and long-term technology-enabled solutions
- Provides expertise and works across departments and with senior leadership to solve organizational issues
- Compliance with all applicable laws and regulations
- Other duties as assigned
Qualifications
- A bachelor’s degree or 4 years commensurate experience
- 10+ years experience in health plan operations, health insurance, and/or data analysis or consulting in the healthcare space
- 7+ years of experience building, coaching and developing technical or operational teams within healthcare
- 6+ years experience in analytics & ability to derive insights from complex, broad datasets
- 6+ years in designing and improving workflows as well as standing up accompanying operating and technical procedures
- Experience in health plan configuration, specifically benefit concepts
Bonus Points
- An academic and professional background in coding, math, statistics, engineering or data science
- Knowledge management, training, or content development in operational settings
- Process Improvement or Lean Six Sigma training
- Working knowledge of contract and rate configuration
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraudhere.
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 ([email protected]) to make the need for an accommodation known.
Artificial Intelligence (AI) Guidelines: Please see our AI Guidelines for the acceptable use of artificial intelligence during the interview process at Oscar.
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.
