Claims Compliance Associate Director - Regulatory Strategy

Oscar Health; Phoenix (AZ); Hybrid; USD 134,000 - 176,000; Full time

Benefits offered by this job

Unlimited vacation

Annual performance bonus

Medical, dental, vision benefits

Job summary

Oscar Health in Tempe, Arizona is seeking an Associate Director, Claims Compliance to lead a team of analysts handling regulatory inquiries and exams. The role ensures adherence to state and federal regulations and partners across operations to strengthen claims compliance, reporting to the Senior Director, Claims Quality and Compliance.

This position is based in Tempe with a hybrid schedule requiring three in-office days per week; the base pay is $134,136 - $176,053 per year, plus benefits and

Qualifications

• 7+ years of experience in claims operations, insurance products, and regulatory language.
• 5+ years of people management and leading multiple high-value projects.
• Proven background collaborating with regulatory agencies and regulatory requirements.
• Experience forming data-driven, concrete answers with imperfect information.

Responsibilities

• Direct and coordinate aspects of Oscar claims processes including research, adjustments, and regulatory inquiries.
• Lead a team of claims analysts specializing in regulatory compliance and external responses.
• Influence departmental strategy with quantitative and qualitative inputs to drive success.
• Translate the claims strategy into business plans and tactics to meet KPIs and SLAs.
• Create structure to achieve programmatic and departmental goals.
• Collaborate with other departments on claims issues and inter-departmental projects.
• Supervise and train managers and staff as needed.
• Work with regulatory agencies, Oscar's legal, audit, and compliance teams.

Skills

Claims operations

Regulatory compliance

People management

Leadership

Data-driven decisions

Education

Bachelor's degree

Job description

Oscar Health in Tempe, Arizona is seeking an Associate Director, Claims Compliance to lead a team of analysts handling regulatory inquiries and exams. The role ensures adherence to state and federal regulations and partners across operations to strengthen claims compliance, reporting to the Senior Director, Claims Quality and Compliance.

This position is based in Tempe with a hybrid schedule requiring three in-office days per week; the base pay is $134,136 - $176,053 per year, plus benefits and