Senior Director of Claims - Remote

Overview

The Senior Director of Claims is responsible for continuous improvement and compliance of claims operations, processes, and systems at Oscar, a health insurance company focused on serving its members.

In Short

• Lead and grow a team focused on claims quality and optimization.
• Establish best in class standards for claims operational performance.
• Collaborate with Operations and Technology teams to improve claims systems.
• Ensure compliance with industry regulations and internal policies.
• Identify and mitigate claims processing risks.
• Monitor claims processing to meet performance metrics.
• Oversee investigation and settlement of complex claims.
• Work with tech partners for process optimization.
• Drive continuous improvement of claims processing procedures.
• Manage claims remediation plans and ensure adherence to best practices.

Requirements

• Bachelor's degree or 4 years of relevant experience.
• 15+ years in a cross-functional operations environment.
• 3+ years in a health plan/payer role.
• Extensive knowledge of claims operations and insurance products.
• Experience in process analysis and improvement.
• Ability to work with technical teams for process support.
• Strong people management and leadership skills.
• Data-driven decision-making abilities.
• Excellent communication skills.

Benefits

• Eligible for employee benefits and unlimited vacation program.
• Participation in company equity grants.
• Annual performance bonuses.
• Medical, dental, and vision benefits.
• Paid holidays and sick time.
• Paid parental leave.
• 401(k) plan participation.
• Life and disability insurance.
• Paid wellness time and reimbursements.