Senior Specialist, Process improvement (SIU)

Summary

About the role This Senior Specialist, Process improvement (SIU) is responsible for supporting process improvement and issue resolution in the Oscar Special Investigations Unit (SIU) for all Oscar Insurance business. The Senior Specialist, Process Improvement role organizes, scopes, triages, investigates and/or executes on solutions and process improvements. You will accomplished by leveraging a deep understanding of Oscar's SIU, claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement.You will report into the Director, SIU.Work Location Work Location: This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events.Pay Transparency The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $75,348 - $98,894 per year. The base pay for this role in all other locations is: $67,813 - $89,005 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.Responsibilities SIU Operations & Incident Response: Conduct Special Investigations Unit (SIU) intake, triage, and tip research. Support operational goals by providing rapid root cause analysis and training for escalated issues.Risk Mitigation & Problem Resolution: Identify operational risks in coordination with leadership, investigating and resolving issues to inform short-, medium-, and long-term technology-driven solutions.Stakeholder Feedback & Solutions: Scope, prioritize, and deliver effective solutions based on internal and external partner feedback regarding adverse claim outcomes.Data Analysis & Technical Requirements: Use data analysis tools to produce quantitative insights, translating findings into detailed technical business requirements for cross-functional partners.Proactive Improvement: Leverage insights from partner submissions, data mining, and process monitoring to identify and address systemic areas of opportunity.Operational Organization: Maintain accurate records in accordance with the organization's retention policies, ensuring files are securely stored and accessible. Support consistent team organization through clear documentation, standardized filing practices, and routine upkeep of the shared systems.Project & Process Management: Coordinate key projects to meet service level agreements and milestones, supporting financial discipline, quality, and continuous improvement.Cost Optimization & Compliance: Partner with leadership and cross-functional teams to implement initiatives aimed at reducing overall costs, enhancing outcomes, and ensuring compliant business operations.Stakeholder Communication: Maintain transparency by keeping key stakeholders informed of project progress, status updates, and blockers.Compliance with all applicable laws and regulationsOther duties as assignedRequirements A Bachelor's degree or 4+ years of commensurate experience2+ years experience in a technical role (QA analyst, PM, operations analyst, finance, consulting, industrial engineering) or a process improvement role (Six Sigma or similar)2+ years of experience working with large data sets using excel or a database language1+ years experience deriving business insights from datasets and solving problems1+ years experience improving business workflows and processes1+ years experience collaborating with internal and/or external stakeholdersBonus points An academic and/or professional background in engineering, data, or healthcareExperience in a professional healthcare claims organizationExperience working in or with an SIUKnowledge management, training, or content development in operational settingsProcess Improvement or Lean Six Sigma training aidsExperience using SQLEqual Opportunity At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.This is an authentic Oscar Health job opportunity.Pay Transparency: Final offer amount#J-18808-Ljbffr

Job Description

About the role This Senior Specialist, Process improvement (SIU) is responsible for supporting process improvement and issue resolution in the Oscar Special Investigations Unit (SIU) for all Oscar Insurance business. The Senior Specialist, Process Improvement role organizes, scopes, triages, investigates and/or executes on solutions and process improvements. You will accomplished by leveraging a deep understanding of Oscar's SIU, claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement.You will report into the Director, SIU.Work Location Work Location: This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events.Pay Transparency The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $75,348 - $98,894 per year. The base pay for this role in all other locations is: $67,813 - $89,005 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.Responsibilities SIU Operations & Incident Response: Conduct Special Investigations Unit (SIU) intake, triage, and tip research. Support operational goals by providing rapid root cause analysis and training for escalated issues.Risk Mitigation & Problem Resolution: Identify operational risks in coordination with leadership, investigating and resolving issues to inform short-, medium-, and long-term technology-driven solutions.Stakeholder Feedback & Solutions: Scope, prioritize, and deliver effective solutions based on internal and external partner feedback regarding adverse claim outcomes.Data Analysis & Technical Requirements: Use data analysis tools to produce quantitative insights, translating findings into detailed technical business requirements for cross-functional partners.Proactive Improvement: Leverage insights from partner submissions, data mining, and process monitoring to identify and address systemic areas of opportunity.Operational Organization: Maintain accurate records in accordance with the organization's retention policies, ensuring files are securely stored and accessible. Support consistent team organization through clear documentation, standardized filing practices, and routine upkeep of the shared systems.Project & Process Management: Coordinate key projects to meet service level agreements and milestones, supporting financial discipline, quality, and continuous improvement.Cost Optimization & Compliance: Partner with leadership and cross-functional teams to implement initiatives aimed at reducing overall costs, enhancing outcomes, and ensuring compliant business operations.Stakeholder Communication: Maintain transparency by keeping key stakeholders informed of project progress, status updates, and blockers.Compliance with all applicable laws and regulationsOther duties as assignedRequirements A Bachelor's degree or 4+ years of commensurate experience2+ years experience in a technical role (QA analyst, PM, operations analyst, finance, consulting, industrial engineering) or a process improvement role (Six Sigma or similar)2+ years of experience working with large data sets using excel or a database language1+ years experience deriving business insights from datasets and solving problems1+ years experience improving business workflows and processes1+ years experience collaborating with internal and/or external stakeholdersBonus points An academic and/or professional background in engineering, data, or healthcareExperience in a professional healthcare claims organizationExperience working in or with an SIUKnowledge management, training, or content development in operational settingsProcess Improvement or Lean Six Sigma training aidsExperience using SQLEqual Opportunity At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.This is an authentic Oscar Health job opportunity.Pay Transparency: Final offer amount#J-18808-Ljbffr