Medical Director, Clinical Regulatory Affairs jobs in United States
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Oscar Health · 4 days ago

Medical Director, Clinical Regulatory Affairs

positionUnited States
timeFull-time
remoteRemote
senioritySenior Level, Lead/Staff
money$219K/yr - $287K/yr
date10+ years exp

Oscar is a health insurance company focused on serving its members through a full stack technology platform. The Medical Director will oversee Clinical Policy, Regulatory, and Compliance functions within the Office of Clinical Affairs, ensuring operations meet healthcare laws and standards while advising senior leadership on compliance risks and strategies.

Health CareHealth InsuranceInsuranceInsurTech
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H1B Sponsor Likelynote

Responsibilities

Lead and grow the Clinical Policy & Regulatory Affairs team
Build and manage processes that ensure clinical policy compliance and quality
Develop and maintain BIPs, SOPs, and other clinical policy documents aligned with QMS
Serve as a regulatory compliance expert and maintain strong relationships with key clinical teams
Deliver executive briefings on regulatory and policy impacts
Advise the CMO and senior leaders on compliance risks and strategy
Support interactions with federal and state regulators (FDA, CMS, state DOI)
Oversee the Clinical Coding Center of Excellence and clinical credentialing
Promote a culture of compliance through training and education
Collaborate effectively with stakeholders across the organization

Qualification

MDDO licenseClinical policy complianceRegulatory affairs experienceHealthcare industry experienceTeam leadership experienceLegal trainingACACollaboration skills

Required

Active, unrestricted MD or DO license
10+ years of experience in healthcare or the health insurance industry
5+ years of experience in clinical policy compliance or clinical regulatory/government affairs
5+ years applying state and federal health insurance laws and regulations (Marketplace, MA, reporting, and audit requirements)
5+ years preparing and presenting reports to boards of directors
5+ year of team leadership and people development experience

Preferred

JD or other legal training/certification
Experience with ACA or commercial health plans
Experience working in a fast-paced, collaborative environment

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

Company

Oscar Health

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Oscar is a health insurance company that offers individual and family plans, medicare advantages, and small group products.
dateFounded in 2012
location
New York, New York, USA
people-size1001-5000 employees
web-link
http://www.hioscar.com

H1B Sponsorship

Oscar Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (19)
2024 (24)
2023 (22)
2022 (36)
2021 (13)

Funding

Current Stage
Public Company
Total Funding
$1.99B
Key Investors
Tiger Global ManagementAlphabetFounders Fund
2025-09-16Post Ipo Debt· $355M
2021-03-03IPO
2020-12-17Private Equity· $140M

Leadership Team

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Mark Bertolini
Chief Executive Officer
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Steven B. Kelmar
Executive Vice President & COS
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Recent News

MarketWatch
Why Trump’s ‘Great Healthcare Plan’ strikes Wall Street as so underwhelming
2026-01-17
Benzinga.com
Oscar Health Stock Soars After ACA Subsidy Extension, Barclays Upgrade
2026-01-16
Sherwood News
ACA enrollment deadline arrives with Congress still at an impasse over subsidies
2026-01-16
Company data provided by crunchbase