Remote Senior SIU Process Improvement Specialist

OpenKrill; United States; Remote; USD 68,000 - 90,000; Full time

Job summary

Oscar Health is hiring a Senior Specialist, Process Improvement (SIU) to support the Special Investigations Unit. You will scope, triage, investigate and drive improvements across claims workflows, data models, and tooling, translating friction into actionable opportunities.

You’ll collaborate with stakeholders and leadership to deliver rapid root-cause analysis, define technical requirements, and implement cost- and risk-reducing enhancements while maintaining compliant operations.

Qualifications

• Bachelor's degree or 4+ years of commensurate experience.
• 2+ years experience in a technical role or process improvement role.
• 2+ years working with large data sets using Excel or a database language.
• 1+ years deriving business insights from datasets and solving problems.
• 1+ years improving business workflows and processes.
• 1+ years collaborating with internal and/or external stakeholders.

Responsibilities

• SIU operations and incident response: intake, triage, and research; provide rapid root cause analysis and training.
• Identify operational risks and coordinate with leadership to resolve issues with tech-driven solutions.
• Scope, prioritize, and deliver solutions based on stakeholder feedback on adverse claim outcomes.
• Use data analysis tools to produce quantitative insights and translate into technical requirements.
• Leverage submissions, data mining, and process monitoring to identify opportunities for improvement.
• Maintain accurate records and documentation; ensure secure storage and standardized filing.
• Coordinate key projects to meet SLAs and milestones with focus on quality and continuous improvement.
• Partner with teams to reduce costs while ensuring compliant operations.
• Keep stakeholders informed on progress, blockers, and status.

Skills

Data analysis

Excel

SQL

Problem solving

Stakeholder collaboration

Education

Bachelor's degree or 4+ years experience

Tools

SQL

BI tools

Job description

Oscar Health is hiring a Senior Specialist, Process Improvement (SIU) to support the Special Investigations Unit. You will scope, triage, investigate and drive improvements across claims workflows, data models, and tooling, translating friction into actionable opportunities.

You’ll collaborate with stakeholders and leadership to deliver rapid root-cause analysis, define technical requirements, and implement cost- and risk-reducing enhancements while maintaining compliant operations.