Remote Claims Compliance Associate Director

Namely; Dallas (TX); Remote; USD 134,000 - 176,000; Full time

Benefits offered by this job

Employee benefits

Unlimited vacation

Annual bonuses

Medical coverage

Dental coverage

Vision benefits

11 paid holidays

Paid sick time

Parental leave

401(k) plan participation

Life and disability insurance

Wellness time & reimbursements

Job summary

Oscar is hiring an Associate Director, Claims Compliance to lead a team of analysts focused on regulatory inquiries and examinations while strengthening claims compliance across the health insurance platform.

You will partner with regulators and internal teams to translate strategy into actionable programs and improve regulatory performance. This remote role is open to candidates residing in Dallas, Texas and surrounding areas.

Qualifications

• 7+ years of demonstrated experience in claims operations, insurance products, and regulatory 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.
• 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

Claims operations

People management

Regulatory investigations

Data-driven insights

Job description

Oscar is hiring an Associate Director, Claims Compliance to lead a team of analysts focused on regulatory inquiries and examinations while strengthening claims compliance across the health insurance platform.

You will partner with regulators and internal teams to translate strategy into actionable programs and improve regulatory performance. This remote role is open to candidates residing in Dallas, Texas and surrounding areas.