风险调整专员
Specialist, Risk Adjustment
你好，我们是Oscar。我们正在招聘一名风险调整专家，加入我们的风险调整团队。
Oscar是首家围绕完整技术平台和对会员服务的不懈专注而建立的健康保险公司。我们在2012年创立Oscar，旨在打造我们自己希望拥有的健康保险公司——一家像家人中的医生一样的公司。
关于该职位：
针对《平价医疗法案》（ACA）业务线的风险调整专家将支持风险调整团队和管理层，以实现既定的个人和部门目标、由医疗保险与医疗补助服务中心（CMS）和卫生与公众服务部（HHS）设定的截止日期，并积极参与建立有效的风险调整流程。你将为我们的回顾性及/或前瞻性风险调整项目相关的日常运营和交付成果提供支持。
你将向风险调整回顾经理汇报工作。
工作地点：
此职位为全远程办公，面向居住在美国的候选人开放，但不包括阿拉斯加；特拉华州；夏威夷；路易斯安那州；蒙大拿州；北达科他州；俄克拉荷马州；西弗吉尼亚州；怀俄明州；以及美国属地。日常工作将在你的家庭办公室完成，偶尔需要出差参加团队会议和公司活动。#LI-Remote
薪资透明度：在加利福尼亚州、康涅狄格州、新泽西州、纽约州和华盛顿州，该职位的基本薪资为每小时29.86至39.19美元。在其他所有地区，该职位的基本薪资为每小时26.87至35.27美元。你还有资格享受员工福利，每年可累积15天的月假。
职责：
- 支持与风险调整相关的日常运营，包括但不限于：医疗记录获取、供应商联系、研究联系方式、创建供应商级别的报告和演示文稿。
- 保持对我们的医疗记录库存和交付成果的掌握，确保我们能够保持或超越目标。
- 与内部和外部合作伙伴进行联系，以提高我们达到获取目标的能力。
- 代表风险调整部门与我们的内部和外部合作伙伴沟通，并帮助推动积极的结果。
- 协助团队监控、跟踪并更新我们的库存状态。
- 深入了解Oscar的日常流程。
- 熟悉内部工具和技术流程，并指出改进的机会。
- 支持你的经理
查看英文原文
Hi, we're Oscar. We're hiring a Specialist, Risk Adjustment to join our Risk Adjustment team.
Oscar is the first health insurance company built around a full stack technology platform and a relentless 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 Specialist, Risk Adjustment for the Affordable Care Act (ACA) line of business supports the Risk Adjustment team and management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will provide support to our daily operations and deliverables related to our Retrospective and/or Prospective Risk Adjustment Programs.
You will report into the Manager, Risk Adjustment Retrospective.
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. #LI-Remote
Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $29.86 - $39.19 per hour. The base pay for this role in all other locations is: $26.87 - $35.27 per hour. You are also eligible for employee benefits, monthly vacation accrual at a rate of 15 days per year.
Responsibilities:
- Support daily operations pertaining to Risk Adjustment including but not limited to: medical record retrieval, provider outreach, researching contact information, creating provider level reports and presentations.
- Maintain a grasp of our medical records inventory and deliverables to ensure we are keeping/exceed pace against goal
- Make outreach to internal and external partners to improve our ability to hit retrieval goals
- Represent Risk Adjustment to our internal and external partners and help influence positive outcomes
- Support team with monitoring, tracking, and statusing our inventory
- Develop an in-depth understanding of day-to-day workflows at Oscar
- Become acquainted with internal tools and technical processes, and highlight areas of opportunity for improvement
- Support your manager by guiding decisions on an ongoing basis
- Compliance with all applicable laws and regulations
- Other duties as assigned
Requirements:
- Bachelor's degree in a relevant field of study or commensurate work experience.
- 1+ years experience in chart retrieval or provider outreach
- 1+ years of experience in Healthcare Operations
- 2+ years of experience with being held to and accomplishing goals
Bonus points:
- 1+ years of experience in risk adjustment
This is an authentic Oscar Health job 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.
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.
Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.
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 Privacy Policy.