Senior Analyst, UM Regulatory Operations at Oscar Health

**Who this is for** This fully remote role is for a Senior Analyst with at least 1 year of experience in healthcare audits, regulatory compliance, or utilizatio

Work type: remote

Location: Remote

Salary: $67,813 – $89,004/yr

Type: Full-time

Summary

**Who this is for** This fully remote role is for a Senior Analyst with at least 1 year of experience in healthcare audits, regulatory compliance, or utilization management, who is eager to support Oscar Health's UM Regulatory Operations team. **Key highlights** You will be instrumental in designing, optimizing, and implementing processes to support regulatory requirements, compliance initiatives, and UM audits, reporting to the Senior Manager of UM Regulatory Operations. **You might be a good fit if you...** - Have 1+ years of experience in healthcare audits or accreditations. - Possess 1+ years of professional experience in utilization management or healthcare operations. - Are proficient in Google Suite or Microsoft Office. - Have experience with interdepartmental collaboration to drive projects.

Job Description

Hi, we're Oscar. We're hiring a Senior Analyst, UM Regulatory Operations to join our UM Regulatory Operations team.

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.

About the role:

You will support the design, optimization, and implementation of processes and improvements to operations in support of achieving organizational goals. You will be responsible to support implementations for regulatory requirements, compliance initiatives, UM audits, and other projects, as needed.

You will report into the Senior Manager, UM Regulatory Operations.

Work Location:This is a remote position, open to candidates who reside in: Georgia, Illinois, Texas, Kentucky, Minnesota, Pennsylvania, Utah.You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

Pay Transparency:The base pay for this role is: $67,813 - $89,004 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

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 cross-functional 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

• 1+ years of experience in healthcare audits, or accreditations supporting NCQA and/or regulatory compliance

• 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 with interdepartmental collaboration with stakeholders to drive projects

• 1+ years of experience supporting state audits and exams

• 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

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.

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