Program Lead, Payor Connections/Interoperability

Oscar Health•Atlanta, GA

4h•$91,659 - $120,303•Remote

About The Position

Oscar is hiring a Program Lead, Payor Connections/Interoperability to join their Risk Adjustment team. This role is responsible for an important interoperability initiative, representing the needs and interests of the Risk Adjustment team. The ideal candidate thrives with ambiguity and autonomy, and is comfortable building an end-to-end process. This role involves working with internal and external Oscar partners to ensure accurate acquisition of healthcare data from multiple provider systems. The position reports into the Director, Risk Adjustment Retrospective.

Requirements

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

Nice To Haves

Risk Adjustment experience
Basic SQL or BQ query writing experience

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