Associate, Risk/Compliance
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About this role
Hi, we're Oscar. We're hiring an Associate, Risk / Compliance to join our Compliance 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:
The Associate, Risk / Compliance ensures that Oscar complies with industry specifications, standards, regulations, and laws. You will review operational practices, create and enforce procedures, and perform regulatory reviews. You will ensure and enforce compliance where required throughout the facility to ensure complete compliance in all areas of the business.
You will report into the Manager, Regulatory Audit Compliance.
Work Location: This position is based in our Tempe, AZ office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid
Pay Transparency: The base pay for this role is: $87,188 - $114,434 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.
Responsibilities:
- Partner with all relevant departments to make sure current compliance levels.
- Provide training to team members regarding regulatory compliance.
- Ensure that all team members are aware of the procedures to be followed to follow compliance requirements.
- Develop and implement compliance improvement plans where required.
- Delegate tasks to other departments to bring compliance levels up.
- Develop reports, to the governing body.
- Assist Regulatory Authorities with completing site visits and external audits.
- Prepare for, and conduct audits alongside external authorities.
- Conduct regular audits in all required areas to ascertain compliance levels.
- Compliance with all applicable laws and regulations
- Other duties as assigned
Requirements:
- Bachelor's Degree or equivalent work experience
- 1+ year experience in health plan compliance
- 2+ years experience with State DOI health insurance rules and regulations, CMS ACA rules and requirements, CMS requirements
- 2+ years experience managing high volume and complicated projects, keeping track of details, and staging work to deliver projects on time
Bonus points:
- MLR, HCRA, CMS APTC audit experience
- Healthcare Finance background
- CHC, CCEC, or similar
- Fluency with State DOI audit and/or reporting obligations
- State DOI audit management experience
- Experience in a start-up and/or health tech environment
- Experience in a TPA setting
This is an authentic Oscar Health job opportunity.
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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