Associate, Regulatory Affairs

New York City, NY - USA

Yearly Salary: $ 96876 - 127149

Posted on: 15 hours ago

Vacancies: 1 Vacancy

Job Summary

Hi were Oscar. Were hiring an Associate Regulatory Affairs to join our Regulatory Affairs.

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 ourselvesone that behaves like a doctor in the family.

About the role:

The Associate Regulatory Affairs is a major contributor and owner of mission-critical workflows to manage the Independent Dispute Resolution assigned jurisdictions you will intake disputes from providers engage in negotiation with business unit support perform all relevant admin functions and ultimately prepare arbitration briefing where needed all while creating and maintaining detailed documentation for tracking purposes. You will work with Regulatory Counsel to update workflows keep tabs on developments to No Surprises Act policies and support the Regulatory Affairs function by serving as an enterprise wide resource on IDR trends.

You will report into the Director Regulatory Affairs.

Work Location: This is a remote position open to candidates who reside in: Arizona Florida Georgia Illinois Iowa Kansas Michigan Missouri Nebraska New Jersey New York North Carolina Ohio Pennsylvania South Carolina Tennessee Texas and Virginia. 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.

If you live within commutable distance to our New York City office (in Hudson Square) or our Tempe office (off the 101 at University Ave) you will be expected to come into the office at least three days each week. Otherwise this is a remote / work-from-home role. Thursdays are a required in-office day for team meetings and events while your other two office days are flexible to suit your schedule.

Pay Transparency: The base pay for this role in the states of New Jersey and New York is: $96876 - $127149 per base pay for this role in all other locations is: $87188 - $114434 per year. You are also eligible for employee benefits participation in Oscars unlimited vacation program and annual performance bonuses.

Responsibilities:

Be the subject matter expert on assigned state and federal policy for provider dispute and IDR matters while applying newly proposed laws and regulations to processes in assigned jurisdictions.
Prepare concise user-friendly briefing based on case needs.
Be the team resource through mentoring team members maintaining workflows and work cross functionally to implement solutions where needed.
Partner with PRO Counsel Regulatory Affairs colleagues and cross functional business partners to problem solve and stand up new processes.
Support optimize sustainable processes which simplify our growing teams outputs while ensuring high quality deliverables.
Manage projects with notable complexity with business area implications developing action plans and managing from start to completion.
Deliver multiple simultaneous and diverse assignments while adhering to strict deadlines.
Support cross-training and knowledge development across Oscar
Perform eligibility reviews of disputed claims to ensure all cases are routed to the appropriate venue
Manage the end-to-end administrative lifecycle of each dispute by maintaining real-time updates on project management boards gathering and redacting member documentation and uploading supporting evidence to the appropriate portal stages within set regulatory deadlines
Independently manage workload and related dependencies in compliance with required regulatory timelines
Compliance with all applicable laws and regulations
Other duties as assigned

Requirements:

Bachelors degree in the humanities legal studies political science public policy public administration public health or other relevant field or a combination of education and experience.
3 years of legal or regulatory experience ideally in the health plan/managed care space.
2 years experience working with state and federal political and legislative processes.
2 years experience legislative tracking software and Google Workspace.
2 years experience with insurance claims appeals or regulatory complaints.

Bonus points:

Experience working with Independent Dispute Resolution is a huge plus
Experience working in personal injury law firms or as a paralegal
Familiarity with the Affordable Care Act and the No Surprises Act Experience with Oscar markets.
Experience working with attorneys and internal stakeholders.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

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. Were on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts within the base pay set forth above are determined by factors including your relevant skills education and experience. Full-time employees are eligible for benefits including: medical dental and vision benefits 11 paid holidays paid sick time paid parental leave 401(k) plan participation life and disability insurance and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications without regard to applicants disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known.

California Residents: For information about our collection use and disclosure of applicants personal information as well as applicants rights over their personal information please see our .

Required Experience:

Hi were Oscar. Were hiring an Associate Regulatory Affairs to join our Regulatory Affairs.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 w...