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Salary: USD 196,733 - 258,212 / annual
Oscar Health is seeking a Senior Director, Enterprise Compliance to lead the execution and continuous improvement of its enterprise compliance program. Reporting to the Chief Compliance Officer, this role provides leadership over key compliance functions including regulatory compliance, regulatory change management and implementation, compliance operations, investigations, monitoring and auditing, policy governance, and compliance education.
In this position, you will anticipate regulatory and industry developments, translate them into enterprise compliance priorities, and partner with cross-functional leaders to identify and mitigate compliance risks, strengthen internal controls, and promote a culture of ethics and integrity. You will exercise significant independent judgment, develop a compliance organization, and serve as a trusted advisor to business leaders on complex healthcare regulatory matters.
Key responsibilities include:
- Leading the execution and continuous improvement of Oscar's enterprise compliance program, including multi-year compliance strategy, annual work plans, risk assessments, policy governance, regulatory change management, monitoring, auditing, and reporting.
- Translating enterprise compliance priorities into relevant operating plans; establishing ownership and governance; allocating resources; developing compliance managers and team members; and leading accountability for measurable outcomes.
- Anticipating regulatory and industry developments and advising senior leaders on their effects for Oscar's products, market participation, business strategy, and operating model.
- Overseeing compliance investigations, hotline reporting, the Special Investigations Unit, fraud-prevention activities, corrective action plans, and remediation efforts.
- Partnering with leaders across Legal, Privacy, Security, Internal Audit, Enterprise Risk, Clinical, Product, Operations, and People teams to embed compliance requirements into business processes and strategic initiatives.
- Setting and upholding enterprise standards for ethics and compliance through education, communications, and awareness initiatives.
- Leading compliance reporting and engagement for executive leadership, Compliance Committee, Board committees, and regulatory examinations; supporting interactions with regulators and external auditors.
Oscar is the first health insurance company built around a full stack technology platform with a relentless focus on serving members. The company was founded in 2012 to create a health insurance company that behaves like a doctor in the family.
REQUIREMENTS:
- 12+ years of progressively responsible experience in healthcare compliance, regulatory affairs, legal compliance, audit, or enterprise risk management.
- 5+ years leading high-performing compliance teams and enterprise-wide compliance initiatives.
- Demonstrated experience designing, implementing, and maintaining an effective healthcare compliance program aligned with OIG Compliance Program Guidance and applicable federal and state regulations.
- Experience supporting highly regulated healthcare organizations, including health plans, managed care organizations, healthcare technology companies, provider organizations, or related entities.
- Track record of anticipating regulatory developments and translating them into enterprise priorities, operating plans, and business controls.
- Demonstrated experience leading complex compliance investigations, monitoring and auditing activities, regulatory risk assessments, corrective action planning, and policy governance.
- Experience advising senior business leaders on complex regulatory and operational compliance issues and leading their resolution.
- Strong written and verbal communication skills; experience presenting to executive leadership, governance committees, regulators, or external auditors.
BONUS QUALIFICATIONS:
- Experience supporting Marketplace and other applicable government or commercial health-plan products.
- Experience leading compliance in a technology-enabled, rapidly scaling, or operationally complex healthcare organization.
- Experience using data, technology, and automation to improve compliance monitoring, reporting, and program effectiveness.
- Healthcare compliance certification such as CHC, CHPC, CCEP, or comparable certification.
- JD, master's degree, or other relevant advanced education.
