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Oscar Health // health insurance
 
New York City    Posted: Thursday, December 31, 2020
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. Were hiring a Senior Manager, Clinical Practice Compliance to join our Oscar Medical Group team in our New York office. 

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:

Oscar Medical Group is looking for an experienced clinical practice Compliance Sr Manager to support the telehealth practices growth & ensure that our members continue to receive the high-quality care they deserve. You will own the end-to-end Compliance & Oversight processes for our providers. 

The Compliance Sr. Manager should have knowledge in many areas, including business administration, clinical activities, coding, billing, reimbursement, risk management, & strong familiarity with the laws & regulations applicable to telehealth practices. They must exercise good judgment, prioritize thoughtfully, & - to foster the necessary culture - be approachable.

You will report into the Director, Practice Transformation & Operations

Responsibilities:

  • Design & own the practice compliance & provider quality processes, especially processes related to HIPAA & state-specific regulations pertaining to telehealth.
  • Design & build new processes/systems as needed for provider entities billing practices with respect to government payors.
  • Support the provider entities entry into new states & markets by ensuring preparedness & compliance with applicable clinical practice & telehealth regulations.
  • Develop, coordinate, & if necessary conduct practice compliance training programs for practice staff. Manage maintenance & audit compliance training records 
  • Develop policies & processes for reporting non-compliance issues, including management of the compliance reporting process for all persons associated with the practice.
  • Track & maintain records related to compliance plans, including audit documentation, training resources for practice personnel & agents, screening results, reports of suspected or actual noncompliance, investigations reports & records, & all corrective action plans.
  • Manage the practice compliance budget.

Requirements:

  • College degree
  • 6+ years of relevant experience (e.g., provider-side compliance, telehealth management, practice management, quality setting)
  • Experience with regulatory bodies & knowledge of HIPAA & data privacy
  • Knowledge of telehealth, provider-side compliance, & a desire to build a culture of compliance & ethics.

Bonus points:

  • Applicable health care and/or compliance certifications (e.g., AAPC/ CPPM, CPCO; HCCA/CHC; HTE/CCP; SCCE/CCEP)
  • Managerial experience
  • Experience with billing government payors, including Medicare Advantage, & coordination of benefits
  • Strong design to tackle the challenges (and opportunities) posed by telemedicine/health

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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