By 2020, not only will Oscar offer commercial products beyond our nine current states, but we will also begin to offer Medicare Advantage (MA) products. As we expand into new geographies & lines of business, we have restructured our Compliance Department to embed Compliance subject-matter experts in most operational departments. The Director, Operational Compliance will shape the roles, responsibilities, & successes of these new Compliance roles ensuring that, in all states & lines of business, Oscars functional areas operationalize new laws & regulations, monitor their own performance against regularly updated policies & procedures, & are both audited & audit-ready. Based in Oscars New York headquarters, the Director, Operational Compliance will report to the Vice President, Compliance & Regulatory Affairs.
Deliverables: What you have to achieve
In your first six weeks, you will:
- Familiarize yourself with Oscars structure, operations, & risk assessment & mitigation activities
- Work with direct reports to set company-wide standards for policy & procedure development & design; reporting on operational monitoring; & operational audits
By the end of month 3, you will:
- Roll out the new standards for policies & procedures, monitoring, & audits
- Develop a work plan for audit-readiness, including close work with the Director, Core Compliance to prepare for the pre-market-entry CMS audit of Oscars MA program
- Identify key compliance metrics in the commercial & MA markets for reporting to the Corporate Compliance Committee
- Work with the Legal Department to develop a structured process for the interpretation, dissemination, & implementation of new laws & regulations
Afterwards & on an ongoing basis, you will:
- Work with operational teams to automate the processes by which business areas are monitored for compliance with governing laws & regulations
- Work with the Director, Core Compliance to develop structured processes for Oscars response to audit activities, including CMS Program Audits
- Ensure that Oscars Operational Compliance Team scales appropriately as Oscar continues to grow
- Maintain close communication between, & make periodic in-person visits to, Oscars New York- & Tempe-based Compliance teams
- Collaborate & coordinate with Oscars Internal Audit function to alleviate duplicative activities while holding business functions to account
Winning factors: What leads to success
We are looking for someone with a deep knowledge of the commercial & MA markets who will promote a culture of compliance, ethics, & audit-readiness across all of Oscars operations.
Must-have qualifications & expertise include:
- College degree
- 9+ years experience in a healthcare compliance setting, including managerial experience
- Experience growing & scaling a team & increasing operational efficiency in fast-paced environment or at a start-up
Preferred qualifications include:
- CHC, CCEC, or similar
- Experience with MA compliance, including undergoing a full CMS Program Audit
- Experience with HIPAA, data privacy, or data security processes
We think you will be successful if...
- You are a critical thinker who can distill complex concepts & regulatory requirements into easy to understand action items
- You have acute attention to detail & always strive for perfection when writing formal documents.
- You get things done, even if its crunch time
- You enjoy working in a collaborative environment & working cross-functionally with all business areas within the organization
- You are personable, self-starting & organized
- You have a passion for healthcare & a knack for making processes more systematic
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we work to cultivate an environment where exceptional people can be their most authentic selves & find both belonging & support. We're on a mission to change healthcare -- an experience made whole by your unique background & perspectives.
Oscar applicants are considered solely based on their qualifications, without regard to applicants disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (email@example.com) to make the need for an accommodation known.
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