Director, Claims Compliance & Regulatory Excellence

Oscar Health, Inc.; Tempe (AZ); Hybrid; USD 134,000 - 176,000; Full time

Benefits offered by this job

Benefits package

Unlimited vacation

Annual performance bonus

Job summary

Oscar Health, Inc. is seeking a Claims Compliance Associate Director to lead a team of analysts responsible for regulatory inquiries and market conduct exams.

The role ensures adherence to state and federal regulations and partners across Insurance Operations to strengthen claims compliance. Based in Tempe, Arizona, with a hybrid schedule (3 in-office days weekly, Thursdays in-office for meetings), you will translate strategy into actionable plans and coordinate with regulators, legal, audit,

Qualifications

• 7+ years of demonstrated experience in claims operations and processing, insurance products, and regulatory and policy language.
• 5+ years of people management and team leadership experience with ability to prioritize, allocate work and manage across multiple high-value projects at once.
• Proven background collaborating with regulatory agencies and strong familiarity with regulatory requirements.
• Experience forming data-driven, concrete answers in a world with imperfect information.

Responsibilities

• Direct and coordinate aspects of Oscar claims processes including but not limited to: research, adjustments, and regulatory inquiries.
• Lead a team of claims analysts specializing in regulatory compliance, tasked with investigating regulatory inquiries and developing external responses.
• Translates the claims department's strategy into business plans and tactics in order to meet operational KPIs, targets and SLAs.
• Collaborate and communicate with other departments on claims issues, related projects and inter-departmental operations issues while developing effective, actionable solutions.
• Effectively manage processes and inter departmental initiatives through a collaborative approach to ensure timely results or issue resolution.
• Work cross collaboratively with various regulatory agencies, as well as Oscar's legal, audit, and regulatory compliance teams.
• Compliance with all applicable laws and regulations.

Skills

Regulatory compliance

People management

Claims operations

Data-driven analysis

Regulatory liaison

Education

Bachelor's degree

Job description

Oscar Health, Inc. is seeking a Claims Compliance Associate Director to lead a team of analysts responsible for regulatory inquiries and market conduct exams.

The role ensures adherence to state and federal regulations and partners across Insurance Operations to strengthen claims compliance. Based in Tempe, Arizona, with a hybrid schedule (3 in-office days weekly, Thursdays in-office for meetings), you will translate strategy into actionable plans and coordinate with regulators, legal, audit,