Provider Data Operations Analyst II

Hi, we're Oscar. We're hiring a Provider Data Operations Specialist II to join our Provider Lifecycle team.

Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

This is an opportunity that's all about where you've been. Your experience. Your potential. Your skills. Provider Data Operations Analysts work to solve complex issues or concerns impacting our provider data through end to end roster processing. In this role, you will not only ensure provider data is maintained consistently and manage critical/complex data escalations to resolution, but also through this work, positively impact provider experiences and member outcomes. You will be responsible for accurate, efficient, and timely processing of complex provider rosters. You will communicate with our providers and work collaboratively with teams across Oscar to provide efficient and thorough resolution by providing world class service. You understand the importance of a world-class member experience when seeking care and actively identify barriers to member care and member and provider satisfaction to solve for the future. You are able to manage your workload effectively by understanding service level agreements and production expectations and actively communicate roadblocks and areas of opportunity to your team and leadership. The daily tasks of this role will include maintenance, reporting and extracting data for various reports and analyses, and supporting provider data improvement. You will aid in developing and maintaining standards for provider data integrity and quality assurance, coordinate corrective activities to clean the source(s) of truth and manage communication processes with other departments regarding data improvements.

You will report to the Associate Director, Provider Data.

Work Location: 

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. 

If you live within commutable distance to our New York City office ( in Hudson Square), our Tempe office (off the 101 at University Ave), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.  

You must reside in one of the following states: Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

Pay Transparency:

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $49,600 - $65,100 per year. The base pay for this role in all other locations is: $44,640- $58,590 per year. You are also eligible for employee benefits and monthly vacation accrual up to 10 days per year.

Responsibilities

• Maintains existing and incoming provider information to ensure accuracy and quality of the network by supporting complex non-standard provider information processing needs.
• Surface provider information process and technology issues through proactive identification, measurement, and monitoring of our operations and provide feedback to reduce errors, improve processes, and performance
• Utilize provider data information, internal tools, and technical processes to independently drive and track personal business decisions, execute provider data queries, and perform root cause identification, analysis, and diagnosis
• Perform provider information maintenance, reporting, and extracting data for various reports and analytics
• Become a subject matter expert with the ability to support the organization's Provider Operations teams through escalation research and resolution by gaining an understanding of relevant policies, business processes, workflows, and applying understanding to propose issue resolution
• Ability to identify anomalies and problems within provider information and propose solutions based on acquired knowledge
• Directly and indirectly process provider communication related to roster processing, updates, and questions
• Manage provider roster processing and requests from internal and external stakeholders to appropriately triage, escalate, and resolve issues within business SLA's
• Effectively communicate findings and resolutions with providers and internal departments inclusive of internal collaboration with cross-functional stakeholders and teams
• Ability to identify gaps, trends, and systematic issues within workflows, and articulate and translate these processes to all stakeholders in a digestible manner
• Manage queue work and assigned caseload through effective dashboard management while ensuring integrity of information entered into company and external systems
• Ability to work with less structured, complex issues while extracting, transforming, and loading data
• Identifying issues in provider data quality (e.g. duplicate records, missing data) and escalating to the appropriate teams as needed

Qualifications

• 2+ years of work experience in healthcare and/or operations
• 2+ years of intermediate Excel/Google Sheet proficiency
• 2+ years of assessing and comprehending end to end process impact for proposed record changes
• 2+ years of demonstrated experience understanding needs of business and prioritizing appropriate action based on industry and professional knowledge
• 2+ years experience analyzing datasets and troubleshooting basic data nuances with minimal supervision
• 2+ years of inventory management queue experience

Bonus Points

• 2+ years of intermediate proficiency in SQL, BigQuery or similar database language experience
• A bachelor degree/technical certification or equivalent work experience
• Prior work experience in tech and/or healthcare
• Proficiency with non Microsoft business platforms
• Proficiency in using a credentialing or provider data repository
• Experience working in fast-paced environments
• Experience working with large datasets, data verification, data management, data modeling
• Experience with healthcare data such as provider data and/or claims data

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. 

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..

Pay Transparency: 

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.

Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.