Associate, UM Regulatory Operations

2 hours, 21 minutes ago
Full-time
Junior
Project and Program Management
Oscar

Oscar

Oscar is a health insurance company that offers plans for individuals, families, and small businesses. With a focus on humanizing health care through technology, design, and data, Oscar provides easy-to-understand bills, 24/7 access to doctors, and a p...

Insurance
1K-5K
Founded 2012

Description

  • Lead end-to-end management of cross-functional implementations and projects, including planning, stakeholder engagement, and on-time completion.
  • Collect, document, and manage business requirements for internal process and strategic initiatives.
  • Build and manage project plans, document key decisions, and maintain project governance.
  • Analyze data and metrics to evaluate departmental performance and support mitigation strategies.
  • Work with internal and external stakeholders to interpret and apply new and evolving regulations across UM operations.
  • Coordinate regulatory request management, including market conduct exams, URA filings, license renewals, and MHPAEA compliance.
  • Coordinate NCQA deliverables for UM standards.
  • Draft and evaluate UM policies and procedures to ensure compliance with the UM program.
  • Mentor team members and support colleague growth and professional development.
  • Ensure compliance with all applicable laws and regulations.

Requirements

  • Bachelor's degree or 3+ years of commensurate experience.
  • 3+ years of experience in healthcare utilization management operations, health insurance, or a related field.
  • 2+ years of experience supporting regulatory compliance activities, including MHPAEA, market conduct exams, license renewals, NCQA surveys/accreditation, and other regulatory filings.
  • 2+ years of experience with end-to-end project management or process improvement initiatives.
  • 2+ years of experience in regulatory implementation and compliance.
  • 2+ years of experience designing and improving workflows and standing up operating and technical procedures.
  • 2+ years of experience using data tools such as Excel, Microsoft Office, Google Sheets, or GSuite.
  • Experience collaborating with legal, compliance, and cross-functional teams.
  • Experience with process improvement methodologies such as Lean, Six Sigma, or Theory of Constraints.

Benefits

  • Base salary of $87,188 to $118,434 per year.
  • Eligibility for annual performance bonuses.
  • Unlimited vacation program.
  • 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.

Interested in this position?

Apply directly on the company website

Apply Now

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