[Hiring] Manager, Regulatory Complaints @Oscar Health

Role Description

The Manager, Regulatory Operations is responsible for managing the collaborative filing processes with cross-functional stakeholders, inclusive of conducting research and regulatory outreach. This role also oversees the alignment across submission documents, execution of executive signatures, and any required notarizations in submissions to CMS, SBEs, and State DOI’s, while managing the objection cycle through regulatory approval. This position works closely with internal Oscar teams and interfaces with our external federal and state regulators.

You will report into the Senior Manager, Regulatory Operations.

Responsibilities

• Ensure the accurate and timely submission of Oscar’s annual regulatory obligations.
• Maintain a repository of internal procedural guides on filing obligations to support teams and retain institutional knowledge.
• Help maintain and grow relationships with regulatory bodies in the states where Oscar operates.
• Prepare, file, and secure approval and certification of Oscar’s insurance products through the annual Qualified Health Plan (QHP) filings application process (form, binder, rate, network) with state regulators, state exchanges, and Centers for Medicare & Medicaid Services (CMS).
• Compile and maintain filing deadlines for form, binder, rate, and network annual QHP submissions by state and lines of business.
• Manage, train, provide feedback and assign responsibilities for direct reports to support their professional growth.
• Oversee special filings, such as the quarterly (Rate & Benefits Information System) RBIS submission files to CMS to ensure risk adjustment data can be processed timely and/or provider and vendor contract filings.
• Work independently under remote management, encouraging solid relationships with regulators and colleagues.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Qualifications

• Bachelor's degree or commensurate experience.
• 1+ years of SERFF and HIOS experience.
• Demonstrated project management skills.

Bonus Points

• Familiarity with ACA marketplace plans, rules and regulations.

Requirements

• Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.

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.