Specialist, Risk Adjustment

Oscar Health•New York, NY

3h•$27 - $39•Remote

About The Position

Oscar is hiring a Specialist, Risk Adjustment to join their Risk Adjustment team. Oscar is a health insurance company that utilizes a full stack technology platform and focuses on serving its members. The Specialist, Risk Adjustment for the Affordable Care Act (ACA) line of business will support the Risk Adjustment team and management in meeting goals and deadlines set by CMS and HHS, and will be involved in establishing effective Risk Adjustment processes. This role will provide support for daily operations and deliverables related to Retrospective and/or Prospective Risk Adjustment Programs. The position reports to the Manager, Risk Adjustment Retrospective.

Requirements

Bachelor's degree in a relevant field of study or commensurate work experience.
1+ years experience in chart retrieval or provider outreach
1+ years of experience in Healthcare Operations
2+ years of experience with being held to and accomplishing goals

Nice To Haves

1+ years of experience in risk adjustment

Responsibilities

Support daily operations pertaining to Risk Adjustment including but not limited to: medical record retrieval, provider outreach, researching contact information, creating provider level reports and presentations.
Maintain a grasp of our medical records inventory and deliverables to ensure we are keeping/exceed pace against goal
Make outreach to internal and external partners to improve our ability to hit retrieval goals
Represent Risk Adjustment to our internal and external partners and help influence positive outcomes
Support team with monitoring, tracking, and statusing our inventory
Develop an in-depth understanding of day-to-day workflows at Oscar
Become acquainted with internal tools and technical processes, and highlight areas of opportunity for improvement
Support your manager by guiding decisions on an ongoing basis
Compliance with all applicable laws and regulations
Other duties as assigned