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Oscar Health // health insurance
 
New York City, United States    Posted: Wednesday, April 28, 2021
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. Were hiring a Director, Commercial Compliance to join our Compliance 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:

Oscars Compliance Department manages & mitigates regulatory risk as we serve ever more members & clients across in ever more markets. The Compliance Department also proves to our state & federal regulators & exchanges that we can fulfil our core regulatory obligations while providing members with higher-quality, lower-cost care.

As Oscars Director of Commercial Compliance, you will lead all compliance efforts for Oscars licensed entities delivering Qualified Health Plans (QHPs) in the individual & small group markets.  You & your small team will work closely with & be heavily matrixed into the larger Compliance team servicing Oscars tech platform (i.e., Oscars own TPA) called +Oscar.  You will also advise +Oscar on how best to service its third-party QHP clients.

You will report to the Vice President of Compliance, who is the Compliance Officer for the Oscar corporate family.

Responsibilities: 

  • Fulfill the obligations and, if ready, assume the title of Compliance Officer for the Oscar insurance entities that deliver QHPs in 18 states & counting.
  • To the extent necessary, develop & implement Compliance policies specific to these licensed insurance entities (as distinguished from +Oscars Compliance policies).
  • Prepare & deliver compliance reports to the Boards of these entities.
  • Advise the leadership of these entities on all issues of regulatory compliance, drawing where applicable on resources from Oscars Risk, Legal, Tech, Regional P&L, Sales, & Finance teams.
  • Cultivate these entities day-to-day relationships with regulators & state-based exchanges for purposes of compliance reporting, self-disclosures, enforcement actions, & the interpretation of applicable requirements.
  • Serve as the lead contact for, & prepare Oscars QHP-delivering entities for, regulatory audits.
  • In fulfilling all of the above obligations, draw heavily on the Compliance resources of +Oscar.
  • Establish the Compliance targets that +Oscar must meet, & monitor its performance against these targets.
  • Advise +Oscar as it services Oscars own entities as well as an expanding array of strategic partners & QHP clients.
  • Work with others in Oscars Risk & Controls function to manage regulatory risk sustainably but with a relentless focus on growth & innovation.
  • Structure & refine internal reporting & monitoring processes, enabling the boards of Oscars licensed entities to fulfill their compliance & delegate oversight responsibilities.
  • Drive productive, longer-term changes that lead Oscars commercial compliance activities to meet or exceed industry standards for insurers, tech innovators, & public companies.

Requirements:

  • College degree or equivalent experience
  • 9+ years experience in a healthcare compliance setting, including managerial experience
  • Experience with state & federal health insurance statutes, regulations, & marketplace requirements & experience applying this knowledge to meet reporting & audit obligations
  • Experience preparing & delivering reports to boards of directors in a for- or not-for-profit setting
  • Experience providing tactical & strategic advice & identifying the need for, & delivering, education & training to support compliant product growth
  • Team-building & development experience

Bonus points:

  • CHC, CCEC, or similar
  • Experience with Market Conduct Examination requirements (or state-level equivalents)
  • Operational or internal audit experience
  • Experience in a start-up and/or health tech environment
  • Experience preparing & delivering reports destined for a public company board
  • 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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