Utilization Management Liaison Lead

Hi, we're Oscar. We're hiring a Utilization Management Liaison Lead to join our Clinical Review Team Operations.

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

As the Utilization Management (UM) Liaison Lead, you will become an expert on production team workflows to drive goals and key performance indicators for the team of support staff to meet business objectives while providing coaching and leadership. You will partners with team members to manage all appeal levels processed by the UM team and supporting the UM clinicians with post claim clinical review tickets. You will partner with teams to identify and develop workflow improvements to enhance efficiencies for the team.

You will report to the Manager of Utilization Management Processor & Liaison Teams

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 Tempe office (off the 101 at University Dr), we ask you 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: Alabama, Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

Pay Transparency:

The base pay for this role is $48,960 - $64,260 per year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program and annual performance bonuses.

Responsibilities

• Hire and manage a team of Oscar colleagues with direct responsibility for performance management, their growth and development, and associated HR administrative tasks
• Manage your team’s outcomes, monitor dashboards, and track operational KPIs, conducting root-cause analysis and constructing action plans when issues arise 
• Understand and be connected to the type of work your team does daily, being able to make volume-based decisions that best serve our customers. 
• Lead team huddles with Oscar colleagues, connecting colleagues to the mission, vision, and values of Oscar, and providing guidance and motivation to achieve daily operational goals
• Promote team engagement by creating an inclusive and inviting culture that aligns with Oscar’s core values
• Participate in continuous improvement activities that influence the improvement and development of a production team

• Identify and close gaps on existing operational workflows 
• Work collaboratively across production and other Oscar teams to implement best practice

• Compliance with all applicable laws and regulations 
• Other duties as assigned

Qualifications

• 2+ years experience in a customer service environment
• 1+ year of direct people management experience
• 1+ years of experience using data and metrics to guide improvements
• 1+ years of experience working with teams in multiple locations and multiple disciplines

Bonus Points

• Bachelor's degree
• Lean Six Sigma or Process Improvement certification
• Prior healthcare or insurance experience
• Advanced Google Suite or Microsoft Office capabilities
• 2+ years experience solving complex inquiries
• 1+ years managing projects