Associate Director of Claims Compliance

Join Oscar, a health insurance company built around a full stack technology platform. As the Associate Director of Claims Compliance, you will lead a team of analysts responsible for investigating and responding to regulatory inquiries. You will ensure adherence to state and federal regulations, work directly with regulators, and partner across Insurance Operations to strengthen claims compliance. You will report to the Senior Director of Claims Quality and Compliance and collaborate with various regulatory agencies, as well as Oscar's legal, audit, and regulatory compliance teams.

• Lead a team of analysts responsible for investigating and responding to regulatory inquiries, ensuring adherence to state and federal regulations.
• Direct and coordinate aspects of Oscar claims processes, including research, adjustments, and regulatory inquiries, to improve claims compliance and regulatory performance.
• Collaborate and communicate with other departments on claims issues, related projects, and inter-departmental operations issues while developing effective, actionable solutions.

• 7+ years of demonstrated experience in claims operations and processing, insurance products, and regulatory and policy language
• Experience forming data-driven, concrete answers in a world with imperfect information
• Proven background collaborating with regulatory agencies and strong familiarity with regulatory requirements
• 5+ years of people management and team leadership experience with ability to prioritize, allocate work and manage across multiple high-value projects at once
• Bachelor's degree, or 4 years commensurate experience
• Experience with benefit and contract interpretation or coding in professional/ institutional billing requirements
• Experience managing claims across multiple product types ( i.e.Medicare or Commercial)
• Experience analyzing and improving processes and workflows
• Experience working with technical teams (e.g. engineering and product) to communicate our requirements, design tooling, and support technical troubleshooting
• Excellent leadership and communication skills to drive decision-making and results across multiple partners