• The Governance & Control Specialist - Centralized 1B Risk Trending & Reporting will report to the 1B Centralized G&C Risk Identification & Aggregation team. • The individual will support the overall process of the creation of the Risk Profiles and reporting. • In addition, the G&C Specialist - Centralized 1B Risk Trending & Reporting will review and analyze key data sources across Major Risk Categories to assist with identification of risk trends, emerging risks and control gaps across business units and legal entities. • The role contributes to the preparation of risk profile related materials and supports routine monitoring activities.

• Support the 1B Centralized G&C Risk Identification & Aggregation team in overall process and maintenance of Risk Profiles and reporting • Assist with the review and analysis of key data sources across Major Risk Categories to identify risk trends, emerging risks, and control gaps • Provide essential governance and administrative support, including updating procedures, maintaining process maps, organizing documentation, tracking changes, and assisting with report preparation and coordination activities

• Achieves annual new revenue objectives through consultative sales to new clients and expansion of service lines to existing clients. • Exhibits thought leadership & industry engagement through associations, speaking panels and in general demonstrates expertise in selected industry vertical(s). • Develops annual, individual sales plan (ISP) with a pipeline coverage ratio of 5X or one that is in line with current company metrics to ensure stated goals are consistently met. • Builds an active pipeline of qualified prospects, generating leads from personal contacts, client referrals, prospect pursuit campaigns (PPC’s), other Relation colleagues and Relation marketing sources. • Documents new business activity in the appropriate system(s). • Appropriately closes new business, documenting won/loss opportunities and reasons for all clients in the system in place at that time. • Develops and presents recommendations to clients based on consultative selling approach. • Assesses & identifies risk issues, needs and possible uninsurable or difficult to insure exposures for clients. • Recommends and assists clients with technical services including loss control and claims advocacy programs utilizing our in-house loss control and claims advocacy teams. • Seamlessly transitions sold clients to the designated client service/account management team. • Serves as client’s valued advisor, building a strategic and personal relationship with key client decision makers. • Communicates with leadership, providing field input on market trends, competitor analysis and other business intelligence. • Performs other projects, duties, and tasks, as assigned.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Hi, we're Oscar. We're hiring a SIU Investigator to join our SIU 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. The SIU Investigator identifies and investigates aberrant behavior observed in medical claims data and member enrollment data. You will manage an investigative caseload from case identification through to resolution, including: - Data mining - Investigation planning - Data analysis - Sampling - Medical records requests - Audit interpretation - Overpayment recovery - Reporting to regulatory agencies - Monitoring ongoing provider behavior The Senior Analyst will meet metrics set forth related to caseload, turnaround times, and other unit-wide goals. You will report into the Investigations Manager, SIU. Work Location: This is a remote position, open to candidates who reside in: - Arizona - Florida - Georgia - Illinois - Iowa - Kansas - Michigan - Missouri - Nebraska - New Jersey - New York - North Carolina - Ohio - Pennsylvania - South Carolina - Tennessee - Texas - Virginia 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. If you live within commutable distance to our New York City office (in Hudson Square) or our Tempe office (off the 101 at University Ave), you will be expected to come into the office at least three days each week. Otherwise, this is a remote/work-from-home role. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. The base pay for this role in the states of New Jersey and New York is: $72,036 - $94,546 per year. The base pay for this role in all other locations 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. Qualifications - 3+ years of healthcare fraud investigation experience or professional investigation experience with law enforcement agencies - 3+ years experience with applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity Requirements - Bonus points: - Bachelor's degree in Criminal Justice or a related field - Experience with HIPAA, data privacy, and/or data security processes - Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] and Fraud Professional (CAFP), or similar - Certified Professional Coder (CPC) or similar Benefits - Employee benefits including medical, dental, and vision benefits - 11 paid holidays - Paid sick time - Paid parental leave - 401(k) plan participation - Life and disability insurance - Paid wellness time and reimbursements