Senior Analyst, UM Regulatory Operations

Summary

Join Oscar, a health insurance company built on a technology platform, as a Sr. Analyst, UM Regulatory Operations. You will support the design, optimization, and implementation of processes and improvements to operations to achieve organizational goals. This role involves supporting regulatory requirements, compliance projects, Utilization Management audits, and other projects. You will report to the Manager, UM Regulatory Operations and work remotely or from one of Oscar's offices in New York City, Tempe, or Los Angeles. The position requires residing in one of the specified states, with base pay varying by location. You will be eligible for employee benefits, unlimited vacation, and annual performance bonuses.

Requirements

• 1+ years of professional experience in utilization management, healthcare operations and/or compliance, or a related field
• 1+ years of experience in Adobe Acrobat, and Google Suite or Microsoft Office (Sheets/Excel, Docs/Word, Slides/Powerpoint, etc)
• 1+ years of experience supporting state audits and exams
• 1+ years of experience in process improvement, healthcare policy implementation
• 1+ years of experience with interdepartmental collaboration with stakeholders to drive projects

Responsibilities

• Coordinate projects and processes to help support key regulatory and compliance milestones and deliverables
• Partner with leadership to implement regulations, support key state filings, and other projects
• Partner with teams to ensure action plans and process improvements align with project goals, and participate in collaboration with peers and cross-functional stakeholders
• Support audit exams (NCQA, MHPAEA, State)
• Help identify risks; respond to and resolve compliance gaps through regulatory implementation and in response to audits and Corrective Action Plans
• Compliance with all applicable laws and regulations
• Other duties as assigned

Preferred Qualifications

• ACA marketplace, utilization management, healthcare quality and compliance, or provider data experience
• Training or experience applying Continuous Process Improvement or Lean Six Sigma principles
• Experience with project coordination or management in a matrixed organization
• 1+ years of experience in developing and presenting information and recommendations

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