Program Lead, Payor Connections/Interoperability

Oscar HealthNew York, NY
$101,844 - $133,670Hybrid

About The Position

Oscar is hiring a Program Lead, Payor Connections/Interoperability to join their Risk Adjustment team. This role is crucial for an important interoperability initiative, representing the Risk Adjustment team's needs and interests. The ideal candidate thrives in ambiguous and autonomous environments and is comfortable building end-to-end processes. The Program Lead will collaborate with internal and external Oscar partners to ensure the accurate acquisition of healthcare data from multiple provider systems.

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

Benefits

  • medical
  • dental
  • vision benefits
  • 11 paid holidays
  • paid sick time
  • paid parental leave
  • 401(k) plan participation
  • life and disability insurance
  • paid wellness time and reimbursements
  • unlimited vacation program
  • annual performance bonuses
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