[Hiring] Associate, Risk/Compliance @Oscar Health

Role Description

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.
• Ensure and enforce compliance where required throughout the facility to ensure complete compliance in all areas of the business.
• Report into the Manager, Regulatory Operations.

Work Location: This is a remote position, open to candidates who reside in Atlanta, GA. 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.

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.

Qualifications

• 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.

Requirements

• 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.

Benefits

• Medical, dental, and vision benefits.
• 11 paid holidays.
• Paid sick time.
• Paid parental leave.
• 401(k) plan participation.
• Life and disability insurance.
• Paid wellness time and reimbursements.