Oscar is hiring a
Associate

Summary

Join Oscar's Claims Quality team as an Associate, Claims Regulatory Operations and play a crucial role in supporting compliance within Provider Operations.

Requirements

• Demonstrated understanding of Provider operations in the health payer industry
• 3+ years of relevant experience working with operational compliance, regulatory, and data analysis within Claims
• 3+ years experience designing and improving workflows

Responsibilities

• Collaborate with team members and senior leaders to address process gaps and improvements
• Perform data pulls and conduct detailed analysis to support compliance initiatives
• Develop trusting relationships with internal and external stakeholders through effective communication and collaboration
• Review and submit detailed narratives and reports to communicate compliance findings and updates, including responses to Regulator/NCQA requests and examinations
• Oversee the Policies & Procedures review process within Operations, ensuring that all policies and procedures are up-to-date and meet internal requirements as outlined by Compliance team
• Support Oscar team members through knowledge sharing, process documentation, and tooling development
• Assist in preparing for Market Conduct Exams and other regulatory reviews
• Stay informed on business requirements and act on regulatory updates guided by Oscar’s Compliance team to ensure adherence to effective processes and procedures
• Other duties as assigned

Benefits

• 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
• Paid wellness time and reimbursements