Manager, Member & Provider Operational Compliance

Hi, we're Oscar. We're hiring a Manager, Member & Provider Operational Compliance to join our Strategy 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

The Manager, Member & Provider Operational Compliance will ensure compliance excellence and operational integrity while fostering a culture of operational compliance, representing Operations in discussions with regulatory bodies, and ensuring that the organization is prepared for Market Conduct Exams and other regulatory reviews.

You will oversee the development, implementation, and continuous improvement of compliant operational policies and procedures, working closely with associates and senior leaders to identify and address gaps.

You will report to the Director, Strategy.

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, 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: $103,200 - $135,450 per year. The base pay for this role in all other locations is: $92,880 - $121,905 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities

• Be the subject matter expert for operational processes and systems to effectively rBe the subject matter expert for operational processes and systems to effectively represent the Operations organization in regulatory audits and reviews.
• Develop and implement systems and processes to proactively identify potential compliance issues and continuously improve.
• Develop, update, and streamline Policies and Procedures to ensure they are efficient and compliant, and coordinate with various departments to integrate into daily operations.
• Develop team workflows and guidelines that produce consistent and measurable outcomes; train, teach and mentor team members to become more proficient and effective.
• Collaborate across the organization, including owning stakeholder relationships to identify actions to achieve improvements and monitor initiative impact
• Support Oscar team members through knowledge sharing, process documentation, and tooling development
• Other duties as assigned
• Compliance with all applicable laws and regulations

Qualifications

• 5+ years of relevant experience in a operations role within the health insurance industry
• 5+ years experience representing operational units with regulatory bodies including universe pulls, data analysis, and narrative development.
• Experience developing, implementing, and managing Policies and Procedures within a healthcare organization.
• Experience managing and developing a team.

Bonus Points

• Experience managing complicated business challenges: developing understanding, distilling and communicating that understanding to technical and non-technical audiences.
• An academic and professional background in engineering, data, or healthcare
• Knowledge management, training, or content development in operational settings
• Process Improvement or Lean Six Sigma certification
• Structured, systematic, and critical thinking
• Strong verbal and written communications
• 5+ years experience using data software (e.g. Excel, VGA, Macros, SQL and/or Python) to manipulate and analyze large data sets to solve business problems