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Complaints & Grievance Liaison
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What we want you for:
At Oscar, we are changing how health insurance works. We want to create a healthcare experience that’s intuitive and puts people first. We’re using a consumer-focused and tech-driven approach to do so. This positions us uniquely in the space – and creates one of the biggest opportunities in healthcare.
We brought together leaders from top technology, service and healthcare companies to deliver on our promise and seize this opportunity. We all work side by side in a collaborative, energetic, and creative environment. The result: better people, better ideas, and better healthcare.
In this role, you will manage and resolve incoming Member and Provider Complaints and Grievances at our Culver City, CA office. In doing so, you will help us identify trends and improve our processes so that internal escalation paths are clear and our company can continuously work to provide a seamless experience for our members and providers. Additional responsibilities will include working cross-functionally with internal Oscar teams and ‘quarterbacking’ cases towards resolution as efficiently as possible.
In your first month you will –
• Work closely with the Complaints & Grievances team to firmly grasp Oscar’s Complaints policies and processes
• Develop an advanced understanding of how questions and escalations are presented by members and consequently reviewed with the appropriate internal parties for issue resolution
• Start to provide quality feedback to Oscar operations teams (i.e., aggregate information related to complaints & grievances to trends, identify root causes of issues, suggest remediation/mitigation strategies)
On an ongoing basis, you will –
• Work on resolving member and provider complaints and grievances primarily in Oscar’s California and Texas markets
• Address all complaints that are submitted for members and providers within required time frames, as outlined by state regulatory agencies
• Partner with cross-functional internal stakeholders to ensure that processes are continuously refined and improved with an ultimate goal of an enhanced member/provider experience
Winning factors: What leads to success
• Self-starter with excellent communication skills, both written and verbal
• High attention to detail and a curious mind
• Strong team player who enjoys to drive to optimal outcomes across a larger team
• Sound sense of judgment driven by ability to view a situation objectively
• Strong ability to prioritize and manage a high volume of work
• Ability to follow pre-defined workflow and identify process improvements
• Eagerness to pursue the unknown with tenacity
Must-have qualifications and expertise include:
• Bachelor’s degree
• Experience working in the healthcare or start-up industries or a passion to learn about these environments
• Demonstrated capacity to balance competing priorities and continue to execute projects with excellence
• Expressed interest in continuous improvement and process improvement work (e.g., systematically addressing recurring issues through root cause issue resolution)
Oscar is an equal opportunity employer. Should you be a fit for this role, one of our recruiters will contact you from a hioscar.com e-mail address. Oscar recruiters do not request your sensitive personal information by email.