Oscar Health Insurance Co

Manager, Regulatory Reporting

Oscar Health Insurance Co$106K — $140K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree or equivalent experience
  • 5+ years experience in payer organizations
  • 3+ years of leadership experience managing teams
  • 3+ years in healthcare with policies & procedures
  • 3+ years driving compliance with audit/policy requirements
  • 3+ years implementing operational procedures based on regulations
  • 3+ years experience in fast-paced operations environments

Responsibilities

  • Ensure compliance with healthcare regulations like HIPAA and ACA
  • Lead and mentor the regulatory reporting team for timely submissions
  • Coordinate responses for audits and data submission requests
  • Develop dashboards to ensure accuracy in regulatory reporting
  • Collaborate with business leaders to enhance reporting processes
  • Direct teams to meet regulatory submission deadlines
  • Train and communicate compliance topics and best practices

Benefits

  • Medical, dental, and vision benefits
  • 11 paid holidays and paid sick time
  • Paid parental leave
  • 401(k) plan participation
  • Life and disability insurance
  • Unlimited vacation program
  • Paid wellness time and reimbursements
Full Job Description
Hi, we're Oscar. We're hiring a Manager, Regulatory Reporting to join our Compliance team.

About the role:

The Manager, Regulatory Reporting manages Oscar's compliance programs and activities (i.e. regulatory). You will be responsible for overseeing the development, implementation, and management of all compliance programs to align with healthcare regulatory requirements. Additionally, you will assess compliance, alignment, and execution from multiple perspectives, including training material, standard operating procedures, business practices, and external communication.

You will report into the Director, Regulatory Audit & Reporting.

Work Location: This position is based in our New York City 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: $106,812 - $140,190 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:
  • Ensure compliance with healthcare regulations, including HIPAA, Medicare, Affordable Care Act (ACA), and Medicaid.
  • Lead the regulatory reporting team, providing guidance, direction, and mentorship to ensure successful implementation and timely execution of regulatory reporting submissions
  • Coordinate and respond to data submission requests for internal and external audits
  • Develop dashboards and inventory processing method to ensure accuracy of regulatory reporting inventory
  • Collaborate with internal business leaders to improve end-to-end reporting process
  • Direct teams to meet submission timelines
  • Review technical documents for accuracy and quality
  • Proactive problem-solving and risk mitigation
  • Develop relationships with departmental leaders to understand business operations, identify areas of risk, and provide guidance on internal control design and implementation.
  • Provide regular updates to executive management and the Board of Directors including, but not limited to, developing and delivering reports, presentations, and memoranda.
  • Provide training, education, and communication to the enterprise regarding compliance topics and industry best practices.
  • Ensure that all teams are aware of, and complying with, the procedures to follow compliance requirements.
  • Delegate tasks and responsibilities effectively to departmental leads to ensure timely compliance actions.
  • Develop and implement compliance improvement plans where required.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:
  • Bachelor's degree or commensurate work experience
  • 5+ years payer experience
  • 3+ years in leading direct reports and teams
  • 3+ years experience working in health care or related field with Policies & Procedures
  • 3+ years driving compliance with regulatory and accreditation audit/policy requirements
  • 3+ years experience working with regulations and translating into operational procedures
  • 3+ years experience managing several critical, external facing, deliverables simultaneously
  • 3+ years experience / background in a fast-paced operations environment
  • 3+ years experience in implementation, program building, and maintenance

Bonus points:
  • Certification in Healthcare Compliance (CHC), Certified Compliance and Ethics Professional (CCEP), or similar
  • Fluency with State Department of Insurance (DOI) audit and/or reporting obligations
  • State DOI audit management experience
  • Experience in a start-up and/or health tech environment
  • Experience in a Third Party Administrator (TPA) setting


This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

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.

About Oscar Health Insurance Co

Oscar Health Insurance Co. is a technology-driven health insurance company founded in 2012 and headquartered in New York City. The company offers individual and family health insurance plans, as well as Medicare Advantage plans. Oscar Health Insurance Co. uses technology to simplify the health insurance experience for its customers, including a mobile app that allows customers to manage their health insurance policies and access telemedicine services. The company has raised over $1 billion in funding and is valued at over $5 billion.
Learn more about Oscar Health Insurance Co
Size
4,000 employees
Market Cap
$466 million
Industry
Founded
2012
NASDAQ

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