Manager, Regulatory Reporting

Oscar Health; Phoenix (AZ); Hybrid; USD 96,000 - 126,000; Full time

Benefits offered by this job

Unlimited vacation

Annual performance bonuses

Medical, dental, and vision benefits

401(k) plan participation

Job summary

Oscar Health is seeking a Manager, Regulatory Reporting to lead our compliance programs and manage regulatory reporting submissions. The role is based in Tempe, AZ with a hybrid work schedule requiring in-office presence three days per week.

Base pay ranges from $96,130 to $126,171 per year, with benefits and annual performance bonuses. You will oversee the regulatory reporting team, develop dashboards, and coordinate audits while collaborating with leaders to strengthen internal controls and

Qualifications

• Bachelor's degree or commensurate work experience.
• 5+ years payer experience.
• 3+ years leading direct reports and teams.
• 3+ years in health care or related field with Policies & Procedures.
• 3+ years driving regulatory and accreditation audit/policy requirements.
• 3+ years experience working with regulations and translating into operational procedures.
• 3+ years experience managing several critical, external facing, deliverables simultaneously.
• 3+ years experience / background in a fast-paced operations environment.
• 3+ years experience in implementation, program building, and maintenance.

Responsibilities

• Oversee compliance programs to align with healthcare regulations.
• Lead and mentor the regulatory reporting team.
• Coordinate data submissions for internal and external audits.
• Develop dashboards to ensure accuracy of regulatory reporting.
• Collaborate with business leaders to improve end-to-end reporting.
• Ensure timely submission and quality of regulatory documents.
• Provide updates to executive management and the Board.
• Deliver training on compliance topics and best practices.

Skills

Leadership

Regulatory compliance

Payer experience

Healthcare regulatory knowledge

Data analysis

Education

Bachelor's degree or commensurate work experience

Tools

Regulatory reporting software

Job description

Hi, we're Oscar. We're hiring a Manager, Regulatory Reporting to join our Compliance 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

The Manager, Regulatory Reporting manages Oscar's compliance programs and activities (i.e. regulatory). You will be responsible for overseeing the development, implementation, and management of all compliance programs to align with healthcare regulatory requirements. Additionally, you will assess compliance, alignment, and execution from multiple perspectives, including training material, standard operating procedures, business practices, and external communication.

You will report into the Director, Regulatory Audit & Reporting.

Work Location:

This position is based in our Tempe, AZ 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.

Pay Transparency:

The base pay for this role is: $96,130 - $126,171 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities

• Ensure compliance with healthcare regulations, including HIPAA, Medicare, Affordable Care Act (ACA), and Medicaid.
• Lead the regulatory reporting team, providing guidance, direction, and mentorship to ensure successful implementation and timely execution of regulatory reporting submissions
• Coordinate and respond to data submission requests for internal and external audits
• Develop dashboards and inventory processing method to ensure accuracy of regulatory reporting inventory
• Collaborate with internal business leaders to improve end-to-end reporting process
• Direct teams to meet submission timelines
• Review technical documents for accuracy and quality
• Proactive problem-solving and risk mitigation
• Develop relationships with departmental leaders to understand business operations, identify areas of risk, and provide guidance on internal control design and implementation.
• Provide regular updates to executive management and the Board of Directors including, but not limited to, developing and delivering reports, presentations, and memoranda.
• Provide training, education, and communication to the enterprise regarding compliance topics and industry best practices.
• Ensure that all teams are aware of, and complying with, the procedures to follow compliance requirements.
• Delegate tasks and responsibilities effectively to departmental leads to ensure timely compliance actions.
• Develop and implement compliance improvement plans where required.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements

• Bachelor's degree or commensurate work experience
• 5+ years payer experience
• 3+ years in leading direct reports and teams
• 3+ years experience working in health care or related field with Policies & Procedures
• 3+ years driving compliance with regulatory and accreditation audit/policy requirements
• 3+ years experience working with regulations and translating into operational procedures
• 3+ years experience managing several critical, external facing, deliverables simultaneously
• 3+ years experience / background in a fast-paced operations environment
• 3+ years experience in implementation, program building, and maintenance

Bonus Points

• Certification in Healthcare Compliance (CHC), Certified Compliance and Ethics Professional (CCEP), or similar
• Fluency with State Department of Insurance (DOI) audit and/or reporting obligations
• State DOI audit management experience
• Experience in a start-up and/or health tech environment
• Experience in a Third Party Administrator (TPA) setting

This is an authentic Oscar Health job opportunity.

Pay Transparency

• 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):

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Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([e-mail]) to make the need for an accommodation known.

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