Senior Specialist, Issue Management

Oscar Health; Phoenix (AZ); Hybrid; USD 68,000 - 80,000; Full time

Benefits offered by this job

Unlimited vacation

Annual performance bonuses

Medical, dental, and vision benefits

Job summary

Oscar Health is seeking a Senior Specialist, Issue Management to join our Network Operations team in Tempe. The role focuses on designing and scaling processes to resolve critical bottlenecks in provider operations.

You will report to the Senior Manager, Provider Data Operations and work in a hybrid Tempe office with three in-office days per week. The position emphasizes lean, data-driven problem solving and cross-functional collaboration.

Qualifications

• 1+ years of experience in payer or provider operations, provider network management, healthcare operations, or a related field.
• 1+ years of experience using data and metrics to drive improvements.
• 1+ years of experience in process improvement and workflow design.
• 1+ years of experience in developing and presenting information and recommendations aimed at Senior Leadership.

Responsibilities

• Identify risks and resolve issues/escalations through investigation to inform insights for technology-enabled processes and solutions.
• Coordinate projects to meet milestones and service levels.
• Strategize, implement, and manage arrangements to lower costs or improve outcomes.
• Collaborate with cross-functional teams to align action plans with continuous improvement goals.
• Support data management to ensure compliant and performant operations.
• Provide recommendations that ensure financial discipline and quality.
• Identify and implement process improvement initiatives.
• Ensure compliance with applicable laws and regulations.
• Other duties as assigned.

Skills

Payer operations

Data-driven improvements

Process improvement

Job description

Hi, we're Oscar. We're hiring a Senior Specialist, Issue Management to join our Network Operations team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless 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 Specialist, Issue Management supports the design, optimization, and implementation of processes and improvements to provider operations in support of achieving organizational goals. The Senior Specialist is responsible for day to day oversight of our most critical bottlenecks in Operations being resolved. The lead will implement lean, repeatable and scalable tools and techniques and independently represent the team within the broader organization.

You will report into the Senior Manager, Provider Data Operations

Work Location:

This position is based in our Tempe, Arizona office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule.

Pay Transparency:

The base pay for this role is: $67,813 - $80,000 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities

• With support from leadership, help identify risks; respond to and resolve issues/errors/escalations through investigation to inform insights for short/medium/long-term technology-enabled processes and solutions
• Coordinate projects and processes to help ensure key milestones and service levels are met
• Partner with leadership to strategize, implement, and manage arrangements aimed at lowering overall cost or improving outcomes
• Partner with cross-functional teams to ensure action plans align with continuous improvement goals, and participate in collaboration with peers and cross-functional stakeholders
• Support the management, stewardship, and analysis of data to support compliant and performant business operations
• Provide recommendations that ensure financial discipline and quality
• Support identifying and implementing process improvement initiatives, as well as mindset shifts, to optimize operational efficiency and achieve performance targets
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements

• 1+ years of professional experience in payer or provider operations, provider network management, healthcare operations, or a related field
• 1+ years of experience using data and metrics to drive improvements
• 1+ years of experience in process improvement and workflow design
• 1+ years of experience in developing and presenting information and recommendations aimed at Senior Leadership

Bonus Points

• ACA marketplace, provider network, claims, healthcare quality, or provider data experience
• Management consulting experience
• Training or experience applying Continuous Process Improvement or Lean Six Sigma principles
• Experience with project coordination or management in a matrixed organization
• Experience supporting RFP development and implementation of software or service solutions

This is an authentic Oscar Health job opportunity.

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.

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.

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 ([e-mail]) to make the need for an accommodation known.

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 Privacy Policy.