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Manager, Risk Adjustment Retrospective

Remote:

Full Remote

Contract:

Full time

Salary:

97 - 142K yearly

Experience:

Mid-level (2-5 years)

Work from:

United States

Offer summary

Qualifications:

4+ years in Risk Adjustment program management, 3+ years in project/program management, 3+ years of team management experience.

Key responsabilities:

Manage Risk Adjustment operations and projects
Engage stakeholders and manage vendor relations
Oversee Medical Record Retrieval and goals
Develop strategies for change management
Mentor team members and ensure compliance

Oscar Health Insurance Large https://www.hioscar.com/

1001 - 5000 Employees

See more Oscar Health offers

Job description

Hi, we're Oscar. We're hiring a Manager, Risk Adjustment Retrospective to join our Risk Adjustment Retrospective 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

The Manager, Risk Adjustment Retrospective works with internal and external Oscar partners and represents the needs and interests of the Risk Adjustment team in company wide programs.

You will report to the Director, Risk Adjustment.

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 Dr), 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: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, 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: $108,000 - $141,750 per year. The base pay for this role in all other locations is: $97,200 - $127,575 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities

Management of Retrospective Risk Adjustment operations (non-coding) including implementations/projects, project plan creation, stakeholder engagement, vendor management, subject matter expertise and managing cross-functional relationships to lead collaboration.
First-hand experience of the Medical Record Retrieval process
Track to Medical Record Retrieval goals
Understanding of ACA line of business and RADV process
Collaboratively work with all relevant partner groups to create proactive implementation, communications, and program strategies for successful change management and risk mitigation programs
Oversee team members directly and mentors team members and promotes colleagues’ growth
Compliance with all applicable laws and regulations
Other duties as assigned

Qualifications

4+ years of experience in Risk Adjustment program management/strategy
3+ years of experience providing projects / programs
3+ years of team management experience

Bonus Points

Vendor management experience
Experience using data to improve programs
PMP Certifications or Program Management Certifications
Lean/Six Sigma Certifications
Healthcare experience (Health Insurance, Health Systems, or Healthcare Consulting)

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.

California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Notice to Job Applicants.