Oscar Health Insurance Co

Program Lead, Payor Connections/Interoperability

Oscar Health Insurance Co$91K — $120K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 3+ years in health care operations or health insurance, with direct provider group interaction
  • 2+ years delivering interoperability projects or programs
  • Strong understanding of TEFCA regulations
  • Excellent analytical skills for data evaluation

Responsibilities

  • Lead interoperability projects and manage provider outreach initiatives
  • Develop and cultivate relationships with provider group partners and vendors
  • Create and maintain detailed project plans
  • Formulate operational strategies and market approaches
  • Collaborate with cross-functional teams to drive improvements and evaluate project impact
  • Direct testing and validation of data connections to ensure compliance and functionality
  • Oversee development and enhancement of operational dashboards to meet user needs
  • Manage tracking of project progress and resolve data quality or integration issues

Benefits

  • Medical, dental, and vision benefits
  • Unlimited vacation policy
  • 11 paid holidays
  • Paid sick time
  • Paid parental leave
  • 401(k) plan participation
  • Life and disability insurance
  • Paid wellness time and reimbursements
Full Job Description
Hi, we're Oscar. We're hiring a Program Lead, Payor Connections/Interoperability to join our Risk Adjustment team.

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: Dallas, TX. 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 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. Learn more about how you can safeguard yourself from recruitment fraud here.

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.

About Oscar Health Insurance Co

Oscar Health Insurance Co. is a technology-driven health insurance company founded in 2012 and headquartered in New York City. The company offers individual and family health insurance plans, as well as Medicare Advantage plans. Oscar Health Insurance Co. uses technology to simplify the health insurance experience for its customers, including a mobile app that allows customers to manage their health insurance policies and access telemedicine services. The company has raised over $1 billion in funding and is valued at over $5 billion.
Learn more about Oscar Health Insurance Co
Size
4,000 employees
Market Cap
$466 million
Industry
Founded
2012
NASDAQ

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