Senior Specialist, Process improvement (SIU)

Senior Specialist, Process improvement (SIU) Remote Hi, we’re Oscar. We’re hiring a Senior Specialist, Process improvement (SIU) to join our SIU 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: This Senior Specialist, Process improvement (SIU) is responsible for supporting process improvement and issue resolution in the Oscar Special Investigations Unit (SIU) for all Oscar Insurance business. The Senior Specialist, Process Improvementrole organizes, scopes, triages, investigates and/or executes on solutions and process improvements. You will accomplished by leveraging a deep understanding of Oscar’s SIU, claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement. You will report into the Director, SIU. Work Location: This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $75,348 - $98,894 per year. The base pay for this role in all other locations is: $67,813 - $89,005 per year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program and annual performance bonuses. Responsibilities: SIU Operations & Incident Response: Conduct Special Investigations Unit (SIU) intake, triage, and tip research. Support operational goals by providing rapid root cause analysis and training for escalated issues. Risk Mitigation & Problem Resolution: Identify operational risks in coordination with leadership, investigating and resolving issues to inform short-, medium-, and long-term technology-driven solutions. Stakeholder Feedback & Solutions: Scope, prioritize, and deliver effective solutions based on internal and external partner feedback regarding adverse claim outcomes. Data Analysis & Technical Requirements: Use data analysis tools to produce quantitative insights, translating findings into detailed technical business requirements for cross-functional partners. Proactive Improvement: Leverage insights from partner submissions, data mining, and process monitoring to identify and address systemic areas of opportunity. Operational Organization: Maintain accurate records in accordance with the organization’s retention policies, ensuring files are securely stored and accessible. Support consistent team organization through clear documentation, standardized filing practices, and routine upkeep of the shared systems. Project & Process Management: Coordinate key projects to meet service level agreements and milestones, supporting financial discipline, quality, and continuous improvement. Cost Optimization & Compliance: Partner with leadership and cross-functional teams to implement initiatives aimed at reducing overall costs, enhancing outcomes, and ensuring compliant business operations. Stakeholder Communication: Maintain transparency by keeping key stakeholders informed of project progress, status updates, and blockers. Compliance with all applicable laws and regulations Other duties as assigned Requirements: A Bachelor’s degree or 4+ years of commensurate experience 2+ years experience in a technical role (QA analyst, PM, operations analyst, finance, consulting, industrial engineering) or a process improvement role (Six Sigma or similar) 2+ years of experience working with large data sets using excel or a database language 1+ years experience deriving business insights from datasets and solving problems 1+ years experience improving business workflows and processes 1+ years experience collaborating with internal and/or external stakeholders An academic and/or professional background in engineering, data, or healthcare Experience in a professional healthcare claims organization Experience working in or with an SIU Knowledge management, training, or content development in operational settings Process Improvement or Lean Six Sigma training aids Experience using SQL 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 (View email address on click.appcast.io) 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 . Oscar Health is authorized to do business in many, but not all, states. If you are not located in or willing to relocate to a state where Oscar is registered, you will not be eligible for employment. The approved states for this role are listed in the job posting. Voluntary Self-Identification For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file. As set forth in Oscar Health’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law. If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows: A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability. A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service. An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense. An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985. #J-18808-Ljbffr Oscar Health, Inc.