Senior Analyst, UM Regulatory Operations

Oscar Health

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Job Description

AI Summary

• Supports design and implementation of regulatory compliance processes, including UM audits, state filings, and corrective action plans for a health insurance company • Coordinates cross-functional projects to meet regulatory milestones, partner with leadership on compliance initiatives, and identify/resolve compliance gaps • Requires 1+ years of healthcare audit, accreditation (NCQA), utilization management, or compliance experience, plus proficiency in Adobe Acrobat and Microsoft Office/Google Suite • Fully remote position available in 33+ states with base salary of $67,813-$89,004, unlimited vacation, performance bonuses, and potential future hybrid flexibility • Bonus qualifications include state audit experience, ACA marketplace knowledge, and healthcare quality/compliance background

Hi, we're Oscar. We're hiring a Senior Analyst, UM Regulatory Operations to join our UM Regulatory Operations 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:

You will support the design, optimization, and implementation of processes and improvements to operations in support of achieving organizational goals. You will be responsible to support implementations for regulatory requirements, compliance initiatives, UM audits, and other projects, as needed.

You will report into the Senior Manager, UM Regulatory Operations.

Work Location: This is a remote position, open to candidates who reside in:Alabama; Arizona; Arkansas; Colorado; Connecticut; District of Columbia; Florida; Georgia; Idaho; Illinois; Indiana; Iowa; Kansas; Kentucky; Maine; Maryland; Massachusetts; Michigan; Minnesota; Missouri; Nevada; New Hampshire; New Jersey; New Mexico; North Carolina; Ohio; Oregon; Pennsylvania; Rhode Island; South Carolina; Tennessee; Texas; Utah; Vermont; or Virginia..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: $67,813 - $89,004 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

Responsibilities:

Coordinate projects and processes to help support key regulatory and compliance milestones and deliverables
Partner with leadership to implement regulations, support key state filings, and other projects
Partner with cross-functional teams to ensure action plans and process improvements align with project goals, and participate in collaboration with peers and cross-functional stakeholders
Support audit exams (NCQA, MHPAEA, State)
Help identify risks; respond to and resolve compliance gaps through regulatory implementation and in response to audits and Corrective Action Plans
Compliance with all applicable laws and regulations
Other duties as assigned

Requirements:

1+ years of experience in healthcare audits, or accreditations supporting NCQA and/or regulatory compliance
1+ years of professional experience in utilization management, healthcare operations and/or compliance, or a related field
1+ years of experience in Adobe Acrobat, and Google Suite or Microsoft Office (Sheets/Excel, Docs/Word, Slides/Powerpoint, etc)
1+ years of experience with interdepartmental collaboration with stakeholders to drive projects

Bonus points:

1+ years of experience supporting state audits and exams
ACA marketplace, utilization management, healthcare quality and compliance, or provider data experience
Training or experience applying Continuous Process Improvement or Lean Six Sigma principles
Experience with project coordination or management in a matrixed organization
1+ years of experience in developing and presenting information and recommendations

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.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

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.

California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy.

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Job Information

Company:
Oscar Health
Location:
Remote
Job Type:
Full-Time
Work Location:
Remote
Experience Level:
Senior
Source:
Greenhouse
Status:
Active

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76 /100

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