Associate, Claims Regulatory Operations

Hi, we're Oscar. We're hiring a Associate, Claims Regulatory Operations to join our Claims Quality 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 Associate, Claims Regulatory Operations will play a crucial tactical role in supporting compliance within Provider Operations by analyzing challenges, coordinating responses, and delivering positive outcomes based on inputs from stakeholders. You will advance compliance efforts by conducting detailed data analysis, managing document reviews, overseeing the delivery of Market Conduct Exam exhibits/narratives and the policies & procedures review process within Operations.

You will report to the Sr. Manager, Payment Quality.

Work Location: 

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. 

If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.  

You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

Pay Transparency:

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $93,600 - $122,850 per year. The base pay for this role in all other locations is: $84,240 - $110,565 per year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program and annual performance bonuses.

Responsibilities

• Collaborate with team members and senior leaders to address process gaps and improvements.
• Perform data pulls and conduct detailed analysis to support compliance initiatives.
• Develop trusting relationships with internal and external stakeholders through effective communication and collaboration. 
• Review and submit detailed narratives and reports to communicate …