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About the Role
The Associate, Risk / Compliance ensures that Oscar complies with industry specifications, standards, regulations, and laws. You will review operational practices, create and enforce procedures, and perform regulatory reviews. You will ensure and enforce compliance where required throughout the facility to ensure complete compliance in all areas of the business. You will report into the Manager, Regulatory Operations.
Responsibilities
- Partner with all relevant departments to make sure current compliance levels.
- Provide training to team members regarding regulatory compliance.
- Ensure that all team members are aware of the procedures to be followed to follow compliance requirements.
- Develop and implement compliance improvement plans where required.
- Delegate tasks to other departments to bring compliance levels up.
- Develop reports, to the governing body.
- Assist Regulatory Authorities with completing site visits and external audits.
- Prepare for, and conduct audits alongside external authorities.
- Conduct regular audits in all required areas to ascertain compliance levels.
- Compliance with all applicable laws and regulations
- Other duties as assigned
Requirements
- Bachelor's Degree or equivalent work experience
- 1+ year experience in health plan compliance
- 2+ years experience with State DOI health insurance rules and regulations, CMS ACA rules and requirements, CMS requirements
- 2+ years experience managing high volume and complicated projects, keeping track of details, and staging work to deliver projects on time
- MLR, HCRA, CMS APTC audit experience
- Healthcare Finance background
- CHC, CCEC, or similar
- Fluency with State DOI audit and/or reporting obligations
- State DOI audit management experience
- Experience in a start-up and/or health tech environment
- Experience in a TPA setting
Location
- New York City
Work Type
- Hybrid
Experience Level
- 1+ year experience in health plan compliance
- 2+ years experience with State DOI health insurance rules and regulations, CMS ACA rules and requirements, CMS requirements
- 2+ years experience managing high volume and complicated projects, keeping track of details, and staging work to deliver projects on time
Education Level
- Bachelor's Degree or equivalent work experience
Salary/Compensations
- $96,876 - $127,149 per year
Benefits
- Participation in Oscar's unlimited vacation program
- Annual performance bonuses
- 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
About the Company
- Oscar is the first health insurance company built around a full stack technology platform and a relentless 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.
Equal Opportunity
- At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.