Senior Analyst, Regulatory Affairs

Oscar Health; United States; Remote; USD 71,439 - 104,328; Full time

Benefits offered by this job

Medical, dental, and vision benefits

Unlimited vacation program

Paid parental leave

401(k) plan participation

Job summary

A leading health insurance company seeks a Senior Analyst, Regulatory Affairs, to manage workflows for the Independent Dispute Resolution process. The role involves negotiating disputes, preparing briefings, and staying updated on No Surprises Act policies. Candidates from various states including New Jersey and New York will be considered. This is a remote position with a salary range based on location and experience, along with generous benefits including unlimited vacation and annual bonuses.

Qualifications

• Bachelor's degree in humanities, legal studies, or a relevant field.
• 2+ years of experience managing cross-functional projects.
• Strong communication skills for presenting to stakeholders.

Responsibilities

• Serve as subject matter expert on provider disputes.
• Prepare user-friendly briefings based on case needs.
• Manage the administrative lifecycle of disputes.

Skills

Cross-functional project management

Legislative tracking software

Communication with stakeholders

Education

Bachelor’s degree in relevant field

Tools

Google Workspace

Job description

Hi, we're Oscar. We're hiring an Senior Analyst, Regulatory Affairs to join our Regulatory Affairs. 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 Senior Analyst, Regulatory Affairs is a contributor and owner of mission critical workflows to maintain and operate the Independent Dispute Resolution process. In assigned jurisdictions, you will intake disputes from providers, engage in negotiation with business unit support, perform all relevant admin functions, and ultimately prepare arbitration briefing where needed. You will keep tabs on developments to No Surprises Act policies and support the Regulatory Affairs function in serving as an enterprise wide resource on public policy and IDR trends.

You will report into the Director, Regulatory Affairs.

Work Location

This is a remote position, open to candidates who reside in: Arizona, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Virginia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. If you live within commutable distance to our New York City office (in Hudson Square) or our Tempe office (off the 101 at University Ave), you will be expected to come into the office at least three days each week. Otherwise, this is a remote / work-from-home role. 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 in the states of New Jersey and New York is: $79,488 - $104,328 per year. The base pay for this role in all other locations is: $71,439 - $93,895 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities

• Serve as the subject matter expert on assigned state and federal policy for provider dispute and IDR legislative matters, while applying newly proposed and effective laws and regulations to processes as appropriate in assigned jurisdictions.
• With support from team leads, prepare clear, concise, user friendly briefing based upon case needs.
• Deliver multiple, simultaneous and diverse assignments while adhering to strict deadlines and managing competing priorities in a fast-paced environment.
• Serve as a point of contact for provider negotiations relating to IDR.
• Perform eligibility reviews of disputed claims to ensure all cases are routed to the appropriate venue.
• Manage the end-to-end administrative lifecycle of each dispute by maintaining real-time updates on project management boards, gathering and redacting member documentation, and uploading supporting evidence to the appropriate portal stages within set regulatory deadlines.
• Independently manage workload and related dependencies in compliance with required regulatory timelines.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Requirements

• Bachelor’s degree in the humanities, legal studies, political science, public policy, public administration, public health or other relevant field or a combination of education and experience.
• 2+ years of experience with cross-functional project management experience.
• 2+ years of experience communicating with and presenting information to internal and external stakeholders.
• 2+ years of experience distilling complex issues into digestible action items, for audiences at varying levels of seniority.
• 2+ years of experience with legislative tracking software and Google Workspace.

Bonus Points

• Experience working with Independent Dispute Resolution is a huge plus.
• Experience working in personal injury law firms or as a paralegal.
• Familiarity with the Affordable Care Act and the No Surprises Act.
• Experience with the individual and/or group markets.
• Experience working with attorneys and internal stakeholders.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care — an experience made whole by our unique backgrounds and perspectives.

Pay Transparency (Benefits)

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. 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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