Senior Analyst • Senior

Who you are

You have a strong analytical background with experience in investigating fraud, waste, and abuse (FWA) in healthcare settings. Your ability to manage a caseload from identification through resolution is complemented by your skills in data mining and analysis. You are detail-oriented and capable of documenting findings comprehensively, ensuring compliance with regulatory standards. You thrive in a remote work environment and are comfortable with occasional travel for team meetings and events.

Desirable

Experience in health insurance or a related field is a plus, as is familiarity with medical claims data and enrollment processes. You are proficient in using analytical tools and have a knack for interpreting complex data sets. Strong communication skills are essential, as you will be reporting findings to regulatory agencies and collaborating with various stakeholders.

What you'll do

As a Senior Analyst, SIU Investigator, you will identify and conduct investigations into suspected fraud, waste, and abuse within medical claims and member enrollment data. You will manage an investigative caseload, ensuring timely resolution while meeting established metrics for turnaround times and case management. Your responsibilities will include planning investigations, analyzing data, requesting medical records, and interpreting audit results. You will also be involved in overpayment recovery efforts and monitoring ongoing provider behavior to prevent future issues.

What we offer

Oscar provides a competitive salary range of $64,832 - $85,092 per year, along with comprehensive employee benefits and participation in an unlimited vacation program. You will have the opportunity to work in a supportive environment that values your contributions and encourages professional growth. Join us in our mission to create a health insurance company that prioritizes the needs of its members.