Senior Claims Compliance Lead (Remote)

Oscar Health, Inc.; Dallas (TX); Remote; USD 134,000 - 176,000; Full time

Job summary

Oscar Health, Inc. is seeking an Associate Director, Claims Compliance to lead a team of analysts responsible for investigations and responses to regulatory inquiries, ensuring adherence to state and federal regulations.

The role reports to the Senior Director, Claims Quality and Compliance, with a remote-first setup open to candidates in Dallas, TX. Competitive base pay and eligibility for bonuses are offered.

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.
• 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.
• Work cross collaboratively with various regulatory agencies, as well as Oscar’s legal, audit, and regulatory compliance teams.

Skills

Leadership

Regulatory knowledge

Data-driven decision making

Cross-functional collaboration

Education

Bachelor's degree

Job description

Oscar Health, Inc. is seeking an Associate Director, Claims Compliance to lead a team of analysts responsible for investigations and responses to regulatory inquiries, ensuring adherence to state and federal regulations.

The role reports to the Senior Director, Claims Quality and Compliance, with a remote-first setup open to candidates in Dallas, TX. Competitive base pay and eligibility for bonuses are offered.