Remote Associate Director, Claims Compliance

Namely; Atlanta (GA); On-site; USD 134,000 - 176,000; Full time

Benefits offered by this job

Unlimited vacation

Medical/dental/vision benefits

401(k) plan

Job summary

Oscar Health's Claims team seeks an Associate Director to lead the Claims Compliance function, guiding investigations, regulatory responses, and process improvements.

You will manage a team of analysts, collaborate with regulators and internal partners, and translate strategic goals into actionable plans to strengthen compliance and performance.

This remote role offers a base pay range and benefits, with opportunities for impact across state and federal regulations.

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.
• Creates necessary structure to achieve programmatic and departmental goals.
• Understands and uses business and industry knowledge to inform strategy and execution.
• Supervise and train managers and employees as needed.
• 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.
• Other duties as assigned.

Job description

Oscar Health's Claims team seeks an Associate Director to lead the Claims Compliance function, guiding investigations, regulatory responses, and process improvements.

You will manage a team of analysts, collaborate with regulators and internal partners, and translate strategic goals into actionable plans to strengthen compliance and performance.

This remote role offers a base pay range and benefits, with opportunities for impact across state and federal regulations.