Utilization Review Lead (Non Clinical)

Hi, we're Oscar. We're hiring a Utilization Review Team Lead to join our Clinical Review Team 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 Utilization Review Lead is an expert on production team workflows and guides goals and Indicators for the team of support staff to meet goals while providing coaching and leadership. This role partners with partners to assist members with their health insurance needs, while partnering with partners to identify workflow improvements to enhance efficiencies for the team.

You will report into Associate Operations Manager.

Work Location:

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 Dr), 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, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

Pay Transparency:

Pay Transparency:

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $54,400 - $71,400 per year. The base pay for this role in all other locations is: $48,960 - $62,260 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities

• Hire and manage a team of Oscar colleagues with direct responsibility for performance management, their growth and development, and associated HR administrative tasks
• Manage your team's outcomes, monitor dashboards, and track operational Indicators, conducting root-cause analysis and constructing action plans when issues arise
• Knowledge base of work your team does daily, providing best serve our customers.
• Lead team huddles with Oscar colleagues, connecting colleagues to the mission, vision, and values of Oscar, providing guidance and to achieve daily operational goals
• Be a culture carrier, supporting engagement with your team by creating an inclusive and inviting culture that aligns with Oscar's core values
• Participate in continuous improvement activities that inspire or influence the improvement and development of a high performing production team
• Identify and closing gaps on existing operational workflows
• Work collaboratively across production and other Oscar teams to implement best practice
• Compliance with all applicable laws and regulations
• Other duties as assigned

Qualifications

• 2+ years experience in a customer service environment
• 1+ year of direct people management experience
• 1+ years of experience using data and metrics to drive improvements
• 1+ years of experience working with teams in multiple locations and multiple disciplines

Bonus Points

• Bachelor's degree
• Lean Six Sigma or Process Improvement certification
• Prior healthcare and/or insurance experience
• Advanced Google Suite or Microsoft Office capabilities
• 2+ years experience solving complex inquiries
• 1+ years managing projects