Remote Health Compliance Audit & 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 is a remote position, open to candidates who reside in: Atlanta, GA. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area.

Pay Transparency: The base pay for this role is: $87,188 - $114,434 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, Medicaid and NCQA 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

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

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

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

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Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([email protected]) to make the need for an accommodation known.

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