CGA Team Lead - Remote Compliance & Case Leadership

Oscar Health; Phoenix (AZ); À distance; USD 56 000 - 73 000; Plein temps

Résumé du poste

Oscar Health seeks a CGA Team Lead to supervise day-to-day production operations within the Complaint, Grievances and Appeals team. You will guide staff, ensure cases meet regulatory requirements, and collaborate across the organization to improve member experience.

Reporting to the Associate Manager, CGA & MPCT, you will drive process improvements, manage performance, and support the team in meeting SLAs and TATs while working remotely from home offices in the U.S.

Qualifications

• 3+ years of relevant experience directly related to this role.
• 2+ years experience with and equivalent knowledge of Commercial Insurance, Medicare/Medicaid and/or ACA rules and regulations relating to the Grievance & Appeals processes.
• 1+ years experience with or relevant knowledge of navigating Google Docs and Sheets.
• Management/leadership experience.

Responsabilités

• Manage the day-to-day CGA production operations to ensure compliance with Federal and State regulations and timeframes on all case types.
• Provide coaching, feedback and recognition to direct reports as warranted.
• Monitor performance for direct reports for timely and accurate processing of complaints, grievances, and appeals.
• Identify and coordinate team member training needs based on performance and trends; drive process improvements.
• Act as SME for CGA areas and liaise with other units as needed; ensure compliance with laws and Oscar policies.
• Manage inventory and ensure work is evenly distributed to meet production standards.

Connaissances

Leadership

Team management

Regulatory knowledge

Problem-solving

Formation

Bachelor's Degree

Outils

Google Docs

Google Sheets

Description du poste

Oscar Health seeks a CGA Team Lead to supervise day-to-day production operations within the Complaint, Grievances and Appeals team. You will guide staff, ensure cases meet regulatory requirements, and collaborate across the organization to improve member experience.

Reporting to the Associate Manager, CGA & MPCT, you will drive process improvements, manage performance, and support the team in meeting SLAs and TATs while working remotely from home offices in the U.S.