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Salary: USD 96,876 - 127,149 / annual
Oscar Health is seeking an Associate, Risk/Compliance to join its Compliance team in New York. This role is central to ensuring Oscar complies with all industry specifications, standards, regulations, and laws governing health insurance operations.
You will review operational practices, create and enforce compliance procedures, and perform regulatory reviews across the organization. Key responsibilities include partnering with departments to maintain compliance levels, providing training to team members on regulatory requirements, developing and implementing compliance improvement plans, and delegating tasks to bring compliance standards up to requirements. You will conduct regular audits in all required areas, assist regulatory authorities during site visits and external audits, and prepare compliance reports for the governing body.
The role requires a Bachelor's degree or equivalent work experience, plus 1+ year in health plan compliance and 2+ years with State Department of Insurance health insurance rules, CMS ACA rules, and CMS requirements. You should have 2+ years managing high-volume, complex projects with strong attention to detail and project staging capabilities.
Bonus qualifications include MLR, HCRA, and CMS APTC audit experience; healthcare finance background; compliance certifications (CHC, CCEC); fluency with State DOI audit and reporting obligations; State DOI audit management experience; and background in startups, health tech, or TPA settings.
You will report to the Manager, Regulatory Audit Compliance. The position is hybrid, requiring 3 days in-office per week with Thursdays mandatory for team meetings and events. Base pay ranges from $96,876 to $127,149 annually, with eligibility for employee benefits, unlimited vacation, and annual performance bonuses.
