Senior Manager, Payment Integrity – Chart Review
Oscar
full-time
Posted on:
Location Type: Hybrid
Location: Illinois • Kentucky • United States
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Salary
💰 $111,034 - $145,733 per year
Job Level
About the role
- Lead, oversee, and grow Oscar's internal pre-payment chart review program.
- Lead a team to efficiently manage production inventory issues, ensuring achievement of production and quality targets.
- Anticipate, overcome, and prevent recurrence of complex problems and roadblocks in an efficient and effective manner.
- Establish routines that foster cross-functional collaboration with technology and data science teams to enhance chart review Key Performance Indicators (KPIs): hit rate, change rate, and other productivity metrics.
- Develop and implement standard Payment Integrity policies and procedures.
- Drive ideation of payment integrity opportunities.
- Participate in governance committee activities to ensure alignment with internal stakeholders & business decisions.
- Translate a strategic vision for the team and outline clear and measurable performance metrics / KPIs.
- Coach, develop and lead a team to achieve identified outcomes.
- Provide leadership in complex, cross-functional initiatives focused on claims improvement.
- Manage a portfolio of initiatives and deliverables and proactively identify areas of opportunity to improve key performance indicators.
- Compliance with all applicable laws and regulations.
- Other duties as assigned.
Requirements
- 6+ years experience in operations, data analytics and/or consulting within healthcare
- 6+ years of experience analyzing data to solve complex operational business problems
- 3+ years of experience leading an operations production team
- 3+ years experience designing, implementing and improving business workflows
- Ability to execute on multiple high priority projects within tight deadlines
Benefits
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Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data analyticsoperations managementbusiness workflow designpayment integrityperformance metricsKPI developmentproblem solvingproject managementclaims improvement
Soft Skills
leadershipteam developmentcross-functional collaborationstrategic visioncommunicationcoachinginitiative managementadaptabilitytime management