Program Lead, Payor Connections/Interoperability

Role Description

As a Program Lead, Payor Connections/Interoperability, you will be a key owner of an important interoperability initiative, representing the needs and interests of the Risk Adjustment team. This new role is for you if you thrive with ambiguity and autonomy, and are comfortable building an end-to-end process. You will work with internal and external Oscar partners to ensure accurate acquisition of healthcare data from multiple provider systems. You will report into the Director, Risk Adjustment Retrospective.

Work Location:

• This is a remote position, open to candidates who reside in: Arizona, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, and Virginia.
• You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area.

Pay Transparency:

• The base pay for this role in the states of New Jersey and New York is: $101,844 - $133,670 per year.
• The base pay for this role in all other locations is: $91,659 - $120,303 per year.
• You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

Responsibilities

• Lead interoperability projects with provider outreach.
• Develop relationships with provider group partners and vendors.
• Create and maintain project plans.
• Help develop operational strategy and market approach.
• Collaborate across the organization to identify actions to achieve improvements and monitor initiative impact.
• Direct the testing and validation of data connections to ensure compliance and functionality.
• Oversee the creation and maintenance of essential operational dashboards, and update and enhance them as our user's needs evolve.
• Track development progress, resolve issues related to data quality or integration, and ensure continuous improvement in interoperability programs.
• TEFCA subject matter expert.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Qualifications

• 3+ years of work experience in health care operations or health insurance; working directly with provider groups.
• 2+ years of experience in delivering interoperability projects/programs.
• In-depth knowledge of TEFCA.
• Strong analytical skills.

Bonus Points

• Risk Adjustment experience.
• Basic SQL or BQ query writing experience.

Benefits

• Medical, dental, and vision benefits.
• 11 paid holidays.
• Paid sick time.
• Paid parental leave.
• 401(k) plan participation.
• Life and disability insurance.
• Paid wellness time and reimbursements.