Senior Vice President, Claims Operations
Oscar Health
Hi, we're Oscar. We're hiring a Senior Vice President, Infrastructure Operations to join our Operations 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 Vice President, Infrastructure Operations is charged with setting the standard for excellence in delivering the core functionalities of Oscar’s platform, and is a strategic contributor to Oscar’s strategic direction and approach. Responsible for leading the teams that build, configure, scale and optimize processes related to benefit configuration, claims adjudication, payment integrity, provider data management, enrollment and billing, and regulatory compliance.
You will report to the Chief Operating Officer.
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 Ave), 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, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kentucky, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote
The base pay for this role is: $350,000 - $380,000. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants, and annual performance bonuses.
Responsibilities
Provide the vision and strategy that leads the organization to build scalable processes for benefit configuration, claims adjudication, payment integrity, provider data management, and enrollment and billing.
In partnership with cross functional stakeholders, create a long term Claims strategy that impacts Oscar’s vision
Lead development and cross functional partnering on the building, configuring, and improving of Oscar’s technology platform(s) for adjudicating claims accurately and efficiently
Ensure creation and implementation of management processes for identifying process / system / policy gaps and pain points, root causing issues, and architecting solutions to proactively ensure that our claims process operates at the highest level possible
Work closely with leaders across the organization to ensure successful implementation and execution
Ensure adherence with regulatory and business requirements
Participate in business development efforts with +O client prospects
Develop and coach a team of senior leaders to achieve successful team outcomes
Other duties as assigned
Qualifications
20+ years of experience in a combination of Claims and Healthcare positions
10+ years leading teams to successful outcomes
Bonus Points
Experience or qualification in Lean methodology
Experience in onboarding/implementing B2B client business
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 (accommod[email protected]) to make the need for an accommodation known.