Senior Claims Compliance Director: Regulatory Strategy

name; New York (NY); Hybrid; USD 149,000 - 196,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Oscar Health is hiring a Claims Compliance Associate Director to lead a team of analysts responsible for investigating and responding to regulatory inquiries, including market conduct exams. This role ensures adherence to state and federal regulations and partners across Insurance Operations to strengthen claims compliance.

The Associate Director will transform ideas into implementations, improving regulatory performance and driving KPI achievement.

Qualifications

• 7+ years of experience in claims operations and regulatory language.
• 5+ years of people management and team leadership experience.

Responsibilities

• Direct and coordinate aspects of Oscar claims processes including research, adjustments, and regulatory inquiries.
• Lead a team of claims analysts specializing in regulatory compliance, tasked with investigating regulatory inquiries and developing external responses.
• Influence departmental strategy by providing quantitative and qualitative inputs to drive organization success.
• Translate the claims department's strategy into business plans and tactics to meet KPIs and SLAs.
• Collaborate with other departments and regulators to develop effective solutions.

Skills

Regulatory compliance

Claims operations

People management

Data-driven decisions

Education

Bachelor's degree

Job description

Oscar Health is hiring a Claims Compliance Associate Director to lead a team of analysts responsible for investigating and responding to regulatory inquiries, including market conduct exams. This role ensures adherence to state and federal regulations and partners across Insurance Operations to strengthen claims compliance.

The Associate Director will transform ideas into implementations, improving regulatory performance and driving KPI achievement.