Sr. Analyst, UM Regulatory Operations

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

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

You will report to the Manager, UM Regulatory Operations.

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, Arkansas, 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: $72,800 - $95,550 per year. The base pay for this role in all other locations is: $65,520 - $85,995 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 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

Qualifications

• 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 supporting state audits and exams
• 1+ years of experience in process improvement, healthcare policy implementation
• 1+ years of experience with interdepartmental collaboration with stakeholders to drive projects

Bonus Points

• 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.

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.

Artificial Intelligence (AI) Guidelines: Please see our AI Guidelines for the acceptable use of artificial intelligence during the interview process at Oscar.

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 Notice to Job Applicants.