Associate, UM Regulatory Operations

Hi were Oscar. Were hiring an Associate UM Regulatory Operations to join our 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 ourselvesone that behaves like a doctor in the family.

About the role:

You will be responsible for working cross functionally with business and technical Oscar stakeholders and representing the needs and interests of the department in company wide strategic initiatives and in solving business problems related to internal processes. This requires collecting and documenting business requirements building and managing project plans documenting key project decisions managing project governance applying frameworks analyzing data and developing and communicating risk mitigation strategies across disparate initiatives and stakeholders at the same time.

You will report into the Senior Manager UM Regulatory Operations.

Work Location: This position is based in our Tempe Arizona office requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events while your other two office days are flexible to suit your schedule. #LI-Hybrid

Pay Transparency: The base pay for this role is: $87188 - $118434 per year. You are also eligible for employee benefits participation in Oscars unlimited vacation program and annual performance bonuses.

Responsibilities:

• Lead the end-to-end management of cross-functional implementations/projects including project plan creation stakeholder engagement managing cross-functional relationships to drive collaboration edge case mitigation and on-time completion
• Evaluate overall departmental performance by creating gathering analyzing and interpreting data and metrics as well as assisting in development of departmental metrics and implementation of mitigation strategies
• Collaboratively works with all relevant internal and external stakeholder groups to to interpret and apply new and evolving regulations ensuring consistent understanding and accurate implementation across UM operations.
• Coordinate regulatory request management for the UM department including market conduct exams URA filings license renewals and Mental Health Parity (MHPAEA) compliance.
• Coordinates NCQA deliverables for UM standards
• Evaluates and drafts UM policy and procedures ensuring compliance within the UM program
• Mentor team members and promotes colleagues growth and professional development
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• A bachelors degree or 3 years commensurate experience
• 3 years of work experience in healthcare Utilization Management operations health insurance and/or related field
• 2 years of experience supporting regulatory compliance activities including Mental Health Parity (MHPAEA) market conduct exams license renewals NCQA surveys/accreditation and other regulatory filings
• 2 years of experience with end to end project management or process improvement initiatives
• 2 years of experience in regulatory implementation and compliance
• 2 years of experience in designing and improving workflows as well as standing up accompanying operating and technical procedures

Bonus points:

• 2 years of experience using data software such as Excel Microsoft Office Google Sheets GSuite
• Experience collaborating with legal compliance and cross-functional teams
• Experience with process improvement methodologies such as Lean Six Sigma and/or Theory of constraints

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.

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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.

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