Remote Associate Director, Claims Compliance

Oscar Health; Dallas (TX); On-site; USD 134,000 - 176,000; Full time

Benefits offered by this job

Unlimited vacation

Healthcare benefits

Paid holidays

401(k) plan

Job summary

Oscar Health is seeking an Associate Director of Claims Compliance to lead a team of analysts ensuring adherence to state and federal regulations and supporting regulator inquiries. The role reports to the Senior Director, Claims Quality and Compliance and is remote for candidates residing in Dallas, TX, with potential hybrid adjustments in the future.

The base pay range is $134,136–$176,053 per year, with eligibility for benefits, unlimited vacation, and annual performance bonuses.

Qualifications

• 7+ years of demonstrated experience in claims operations and processing, insurance products, and regulatory language.
• 5+ years of people management and team leadership experience.
• 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.
• Leverages industry background and knowledge of processes to influence others in sensitive complex situations while preserving relationships. Significantly influences departmental strategy by providing quantitative and qualitative inputs that drive organization success.
• 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.

Skills

Regulatory compliance

Leadership

Regulatory inquiries

Cross-functional collaboration

People management

Data-driven decision making

Education

Bachelor's degree

Job description

Oscar Health is seeking an Associate Director of Claims Compliance to lead a team of analysts ensuring adherence to state and federal regulations and supporting regulator inquiries. The role reports to the Senior Director, Claims Quality and Compliance and is remote for candidates residing in Dallas, TX, with potential hybrid adjustments in the future.

The base pay range is $134,136–$176,053 per year, with eligibility for benefits, unlimited vacation, and annual performance bonuses.