Oscar Health · 1 day ago

Manager, Member & Provider Compliance

United States

Full-time

Remote

Mid, Senior Level

$93K/yr - $135K/yr

5+ years exp

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Responsibilities

Be 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

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Health insurance operationsRegulatory complianceProcedures managementData analysisProcess ImprovementData software proficiencyTeam managementLean Six Sigma certificationKnowledge managementStructured thinkingExcelSQLPythonVGAMacros

Required

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.

Preferred

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