Disability Adjudicator Remote Jobs in Atlanta, GA

Hi, we're Oscar. We're hiring a Project Manager- Pharmacy Associate to join our 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 Project Manager is responsible for supporting all activities related to program implementation goals as well as post implementation oversight and monitoring to ensure success. Additionally supports operational improvements for core operations, including proper controls and monitoring, to ensure operational efficiency and effectiveness, supporting the program across the organization and helping implement project management fundamentals and standards across the organization. This individual will establish and manage relationships with key internal and external stakeholders to ensure business alignment and support change management.

You will report into the Director, Pharmacy Programs and Implementation.

Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia. 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: $87,188.40- $114,434.78 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

• Organize and support daily activities based on the goals of the program
• Identify optimization opportunities to support program objectives
• Support implementations end to end to ensure success
• Lead certain components of the program
• Partner with other departments and various stakeholders to ensure operational excellence
• Support a successful program end to end through assisting in project plan development, keeping your stakeholders in the loop on status, proactively flagging, managing escalations, tracking and helping to resolve program risks and milestones, and supporting program retros to assess strengths and weaknesses
• Support the tracking and monitoring of controls
• Develop tools and standards to support team programs year over year based on program retros
• Develop meeting materials, track and follow-up on action items, assist with management of all project plans
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• Bachelor's degree or 4 years commensurate experience.
• 3+ years working for a PBM, Payer, or Pharmacy Consulting firm, with a focus on reviewing healthcare data.
• 3+ years leading cross-functional teams/projects and change management.
• 1+ years working with health insurance regulation/compliance.
• 1+ years working with technical teams, integrations or product management.

Bonus points:

• Experience with medical payer and PBM claims adjudication systems, such as RxClaim.
• Experience with pharmacy claim testing and Quality Assurance (QA).
• Experience with a ticketing system (such as Jira or Appian).
• Experience with Project Management systems (such as Monday.com).
• Experience with payers offering ACA/health exchange insurance.