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Oscar Health // health insurance
 
Los Angeles, California, United States    Posted: Tuesday, August 10, 2021
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. Were hiring a Sr. Analyst to join our Market Conduct Compliance team. 

Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 & headquartered in New York City. Our goal is to make health insurance simple, transparent, & human. We need your help to do so.

About the role:

The Market Conduct Compliance unit ensures that Oscar & its partners are audit-ready, meet their regulatory reporting obligations, & respond to regulatory enforcement actions.  Sitting within the Compliance team that supports & oversees Oscars tech platform, called +Oscar (i.e., the entity that provides management services to Oscars own insurance companies, as well as to its clients & strategic partners), Market Conduct Compliance helps all stakeholders stay in their regulators' good graces.

As a Senior Analyst within the Market Conduct Compliance unit, you will have primary responsibility for managing the reports & external audits touching on Oscars Medicare Advantage (MA) lines of business, as well as those of the MA products offered by +Oscars other clients.  Your role will be to ensure that your colleagues across +Oscar are aware of, are accountable for, & timely submit the MA-specific deliverables that CMS, their federal regulator, expects of them.  You will not be expected to generate all deliverables from scratch; rather, you will develop & maintain the knowledge base necessary to keep other stakeholders informed of their MA audit- & reporting-related obligations, & support them in fulfilling these obligations timely, accurately, & completely.

You will report to the Senior Manager, Market Conduct Compliance.

Responsibilities:

  • Digest, & disseminate to all impacted teams at +Oscar & its licensed insurance entities, the MA audit & reporting obligations imposed by CMS.
  • Track completion, & vet the accuracy & completeness, of all MA deliverables owed to auditors & regulators, as well as to +Oscars clients offering MA products.
  • Under supervision, liaise with audits, regulators, & clients to ensure that +Oscar understands & timely produces all required deliverables.
  • Directly support Oscars Medicare Compliance team when CMS audits Oscars own insurance entities.
  • Use, & constantly seek to improve, the systems through which +Oscar tracks its audit & reporting obligations, & ensures appropriate assignment of ownership & accountability for successful fulfillment of these obligations.
  • Assist with other Market Conduct Compliance activities as required.

Requirements:

  • College degree or commensurate experience
  • 2+ years experience in a healthcare compliance or MA operational setting
  • Exposure to and/or familiarity with MA rules & regulations, including the Medicare Managed Care Manual and/or Prescription Drug Benefit Manual
  • Experience managing complicated projects, keeping track of details, & staging work to deliver projects on time

Bonus points:

  • CHC, CCEC, or similar
  • Experience with MA audit and/or reporting obligations
  • Operational or internal audit experience
  • Experience in a start-up and/or health tech environment
  • Experience in a TPA setting

Life at Oscar: 

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 & find both belonging & support. We're on a mission to change health care -- an experience made whole by our unique backgrounds & perspectives.

We encourage our members to care for their whole selves, & we encourage our employees to do the same with comprehensive medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, & volunteer opportunities.

Reasonable Accommodation:

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 (accommodations@hioscar.com) to make the need for an accommodation known.

Pay Transparency Policy:

Oscar ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.

 
 
 
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