O
1 month ago
Job Summary
The Manager, Claims Quality leads a team tasked with tactical and strategic initiatives with the goal of improving overall claim outcomes driven by audits and payment accuracy across a series of key performance metrics. The Manager plays a critical role in the overall claims improvement apparatus by providing leadership, structure and organization, enabling the team to succeed.
- Minimum Qualification : Degree
- Experience Level : Mid level
- Experience Length : 4 years
Job Description/Requirements
Responsibilities
- Be the subject matter expert for Claims operations through knowledge and expertise of Oscar’s claim platform, claim regulatory requirements and operational workflows
- Manage a complex portfolio of initiatives and deliverables and proactively identify areas of opportunity to improve key performance indicators
- Develop team workflows and guidelines that produce consistent and measurable outcomes; train, teach and mentor team members to become more proficient and effective.
- Managing payment quality outcomes with business partners along with internal and external stakeholders for corporate claims audits.
- Compliance with all applicable laws and regulations
- Other duties as assigned
Qualifications
- A bachelor’s degree or 4+ years of commensurate experience
- 4+ years experience in claims operations, quality and audit.
- 2+ years of experience leading and developing a team
- 2+ years experience designing, implementing and improving business workflows
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