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Senior Analyst, Regulatory Affairs - remote

Oscar Health

Oscar Health

IT, Legal
Remote
Posted on Wednesday, May 3, 2023

Hi, we're Oscar. We're hiring a Senior Analyst, Regulatory Affairs to join our Legal Ops team.

Oscar is the first health insurance company built around a full stack technology platform and a 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 Senior Analyst within the Market Conduct Compliance unit manages the reports and external audits touching on Oscar’s Insurance Co Commercial (on and off exchange) lines of business, Medicare, and those of the +Oscar Commercial and Medicare products offered by clients. You will conduct independent professional analysis ensuring that departments across Oscar are aware of, are accountable for, and timely submit State Department of Insurance (State DOI) regulatory deliverables, such as recurring reports and audit requests.

You will report to the Senior Manager, Regulatory Affairs.

This is a remote / work-from-home role. You must reside in one of the following states: Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $76,000 - $99,750 per year. The base pay for this role in all other locations is: $68,400 - $89,775 per year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program and annual performance bonuses.

Responsibilities

  • Break down, and communicate with all impacted teams within Oscar Insurance Co and +Oscar and its licensed insurance entities, audit and reporting obligations imposed by State DOIs.
  • Track completion, and vet the accuracy and completeness, of all deliverables owed to auditors and regulators for Oscar Insurance Co and to +Oscar’s clients offering Medicare and Commercial state-regulated products.
  • Draft and implement SOPs designed to create best practices and ensure timely, accurate submission of information compliant with State and Federal requirements.
  • Evaluate reports, audits, and exam requests made by regulators to create a risk profile.
  • Directly support Oscar Insurance Co’s Commercial Compliance team when CMS and State DOIs audit Oscar’s insurance entities.
  • Directly support Oscar Insurance Co’s Medicare Advantage team when CMS conducts a Program Audit of Oscar Insurance or +Oscar clients
  • Use, and always try to improve, the systems through which Oscar tracks its audit and reporting obligations, and ensures appropriate assignment for successful fulfillment of these obligations.
  • Update Oscar’s regulatory enforcement tracker, ensuring that the appropriate partners have access to an accurate and complete picture of all enforcement actions related to company operations.
  • Develop the knowledge base necessary to keep other partners informed of their State DOI audit and reporting related obligations, and support them in fulfilling these obligations timely, and completely.

Qualifications

  • Bachelor's Degree or equivalent work experience
  • 1+ year experience in health plan compliance
  • Familiarity with State DOI health insurance rules and regulations, CMS ACA rules and requirements, CMS requirements
  • Experience managing high volume and complicated projects, keeping track of details, and staging work to complete projects on time

Bonus Points

  • CHC, CCEC, or similar
  • Fluency with State DOI audit and reporting obligations
  • State DOI audit management experience
  • Experience in a startup and health tech environment
  • Experience in a TPA setting

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives..

Pay Transparency:

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.

Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.