Hi, we're Oscar. We're hiring a Senior Analyst to join our Payment Integrity 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: This role is responsible for supporting process improvement and issue resolution in the Oscar claim environment for both the Oscar Insurance business and +Oscar clients. The Senior Analyst, Payment Integrity role organizes, scopes, prepares, investigates and/or executes on solutions and process improvements within edits and ideation. This is accomplished by leveraging a deep understanding of Oscar's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement. You will report into the Sr. Manager, Payment Integrity. Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $64,832 - $85,092 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: - Contribute as a subject matter expert for Oscar reimbursement policies, payment integrity internal claims processing edits and external vendor edits. - Respond to internal and external inquiries and disputes regarding policies and edits. - Research industry standard coding rules, summarize and provide input into reimbursement policy language and scope. - Use knowledge gained through research and claims review to ideate payment integrity opportunities. Translate into business requirements; submit to and collaborate with internal partners to effectuate change. - Ingest information from internal and external partners regarding adverse claim outcomes; collaborate with partners to scope, size, prioritize items and deliver solutions. - Use insights from partner submissions, data mining, process monitoring, etc., work with the team to proactively identify thematic areas of opportunity to solve problems. - Perpetuate a culture of transparency and collaboration by keeping stakeholders well informed of progress, status changes, blockers, completion, etc.; field questions as appropriate. - Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc. whenever issues are escalated and assigned by leadership. - Compliance with all applicable laws and regulations - Other duties as assigned Requirements: - A bachelor's degree or 4+ years of commensurate experience - 3+ years of experience in claims processing, coding, auditing or health care claims operations - 3+ years experience in medical coding within payment integrity - Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA) - Experience with reimbursement methodologies, provider contract concepts and common claims processing/resolution practices. - 2+ years experience deriving business insights from datasets and solving problems - 1+ years experience improving business workflows and processes - 1+ years experience collaborating with internal and/or external stakeholders Bonus points: - 2+ years experience in a technical role (QA analyst, PM, operations analyst, finance, consulting, industrial engineering) or a process improvement role (Six Sigma or similar) - Process Improvement or Lean Six Sigma training - Experience using SQL 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. 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.

• Query and analyze large datasets to generate production and ad hoc reports for internal and external stakeholders; support data validation and data preparation efforts. • Manage internal data requests by clarifying stakeholder needs, conducting analyses, and effectively communicating results to end users. • Triage and document stakeholder requests, and support the development of accurate, timely responses. • Support ad hoc analysis requests from leadership, product, marketing and sales. • Serving as a knowledge expert for insurance and claims data processes and identifying areas of improvement to ensure appropriate turnaround times and data quality standards are being met. • Collaborates with data engineering team members to enhance data models, pipelines and reporting infrastructure based on evolving analytical requirements • Translates complex analytical findings into actionable insights and concise presentations for both technical and non-technical audiences • Proactively identify trends, anomalies and opportunities for growth, efficiency and risk mitigation. • Collaborate with cross functional teams to resolve data quality issues and enhance the reporting infrastructure • Ensure data integrity and accuracy across systems and reporting tools. • Support data governance lead with cataloging and documentation of data sources. • Support data definition, documentation, and alignment across product and engineering partners. • Contribute to a growing data culture and support implementation of best practices in analytics methodology and governance.

• Design, maintain, and automate key company dashboards, ensuring they provide actionable insights for the CEO and executive team. • Use AI tools and scripting (Python/SQL) to automate data delivery, reducing manual intervention to the bare minimum. • Conduct thorough research to identify trends, anomalies, and opportunities. • Maintain and evolve our analytical layer (Snowflake/BigQuery), ensuring data is consistent, scalable, and optimized for both human and AI-tooling consumption. • Partner with the Data Engineering team to improve pipelines and documentation. • Support data quality and normalization initiatives.

Role Description The mission of OIGI is to conduct independent investigations into allegations of misconduct involving WFP staff, partners, and other contracted entities or persons. To understand case trends and patterns and to report to stakeholders on statistics, OIGI collects, extracts, and analyzes data from its case management system. The successful candidate will ensure that the data in OIGI’s case management system is complete and accurate, correcting errors as identified and adding missing information as appropriate. The position is home-based and limited to a 90-day engagement. The candidate will report to the Director, Office of Inspections and Investigations (OIGI) or their designate. Accountabilities/Responsibilities - Review case data in the OIGI case management system to identify incomplete fields or inaccurate information. - Obtain accurate case information from the case folder, through review of correspondence and WFP systems, and by liaising with others. - Add information to the case management system in line with applicable naming conventions and other guidance. - Other responsibilities, as assigned. Deliverables at the End of the Contract - Successful completion of tasks listed under above TORs, as assigned. Qualifications - A university degree in data management, finance, statistics, or any other field or relevant work experience. - Previous exposure to investigations, case management systems, and data review or cleaning. - Previous experience working with the United Nations system or other international organizations is desirable. Knowledge & Skills - Analytical Insight: Leveraging analytical tools and methodologies to uncover insights and support decision-making. - Resourcefulness, initiative, maturity, and the ability to work independently. - Strategic Planning: Devising comprehensive plans for effective data management. - Communication and cultural sensitivity: Coordinating effectively with colleagues. 4Ps Core Organisational Capabilities - Purpose - Understand and communicate the Strategic Objectives: Understands WFP's Strategic Objectives and the link to own work objectives. - Be a force for positive change: Flexibly adapts individual contributions to accommodate changes in direction from supervisors and internal/external changes. - Make the mission inspiring to our team: Recognizes and shares with team members the ways in which individual contributions relate to WFP's mission. - Make our mission visible in everyday actions: Sets own goals in alignment with WFP's overall operations, and is able to communicate this link to others. - People - Look for ways to strengthen people's skills: Assesses own strengths and weaknesses to increase self-awareness. - Create an inclusive culture: Participates in open dialogue, and values the diverse opinion of others. - Be a coach & provide constructive feedback: Proactively seeks feedback and coaching to build confidence. - Create an "I will"/"We will" spirit: Participates in accomplishing team activities and goals in the face of challenging circumstances. - Performance - Encourage innovation & creative solutions: Shows willingness to explore and experiment with new ideas and approaches in own work. - Focus on getting results: Consistently delivers results within individual scope of work on time, on budget, and without errors. - Make commitments and make good on commitments: Commits to upholding individual accountabilities and responsibilities. - Be Decisive: Makes rational decisions about individual activities when faced with uncertain circumstances. - Partnership - Connect and share across WFP units: Seeks to understand and adapt to internal or cross-unit teams' priorities. - Build strong external partnerships: Demonstrates ability to understand and appropriately respond to needs of external partners. - Be politically agile & adaptable: Portrays an informed and professional demeanor toward internal and external partners. - Be clear about the value WFP brings to partnerships: Provides operational support on analyses and assessments. Languages - Written and oral proficiency in English is a must for this position. - Fluency in French, Arabic, Spanish, Russian, or Portuguese is an advantage.