Market Conduct / Delegation Oversight Associate

Hi, we're Oscar. We're hiring an Associate, Delegate Oversight to join our Delegation Oversight team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Associate, Delegate Oversight supports the enterprise's compliance program and activities. You will assist in the development of all compliance program activities to ensure understanding of healthcare regulatory requirements. You will assess business unit compliance to laws, regulations, standards, and their procedures by conducting audit and monitoring activities.

You will report into the Sr. Manager, Compliance Audit and Monitoring.

Work Location: This position is based in our New York City office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule.

Pay Transparency: The base pay for this role is: $96,876 - $127,149 per year. You are also eligible for employee benefits, monthly vacation accrual at a rate of 15 days per year and annual performance bonuses.

Responsibilities:

• Help create a risk-based audit and monitoring plan for the healthcare organization.
• Review healthcare regulations, including HIPAA, Medicare, and Medicaid regulations to ensure compliance.
• Conduct assigned audits based on departmental audit plans.
• Partner with teams to understand their business operations and test their compliance with regulations.
• Evaluate compliance effectiveness and identify areas for improvement.
• Draft and complete accurate audit reports, ensuring that the audit findings and conclusions are communicated to the business unit.
• Help identify compliance gaps and risks, and contribute to the development of proactive strategies to address them.
• Help maintain compliance policies, procedures, and controls with regulatory requirements.
• Provide regular updates to leadership on compliance audit and monitoring activities and recommendations.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• Bachelor's Degree or equivalent work experience
• 3+ years experience working in health care or related field
• 3+ years experience in health plan compliance
• 3+ years driving compliance with regulatory and accreditation audit/policy requirements
• 3+ years experience working with regulation and translating into operational procedures
• 3+ years experience / background in a fast-paced environment

Bonus points:

• Certification in Healthcare Compliance (CHC), Certified Compliance and Ethics Professional CCEP, or similar
• Fluency with State DOI audit and/or reporting obligations
• State DOI audit management experience
• Experience in a start-up and/or health tech environment
• Experience in a TPA setting