Medical Director, Clinical Regulatory Affairs

2 weeks, 1 day ago
Full-time
Executive
Operations
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 and grow the Clinical Policy & Regulatory Affairs team.
  • Build and manage processes that ensure clinical policy compliance and quality.
  • Develop and maintain BIPs, SOPs, and other clinical policy documents aligned with the QMS.
  • Serve as a regulatory compliance expert and maintain strong relationships with key clinical teams.
  • Deliver executive briefings on regulatory and policy impacts.
  • Advise the CMO and senior leaders on compliance risks and strategy.
  • Support interactions with federal and state regulators, including FDA, CMS, and state DOI.
  • Oversee the Clinical Coding Center of Excellence and clinical credentialing.
  • Promote a culture of compliance through training and education.
  • Collaborate effectively with stakeholders across the organization.

Requirements

  • Active, unrestricted MD or DO license.
  • 10+ years of experience in healthcare or the health insurance industry.
  • 5+ years of experience in clinical policy compliance or clinical regulatory/government affairs.
  • 5+ years applying state and federal health insurance laws and regulations, including Marketplace, MA, reporting, and audit requirements.
  • 5+ years preparing and presenting reports to boards of directors.
  • 5+ years of team leadership and people development experience.
  • JD or other legal training/certification in addition to physician credentials (preferred).
  • Experience with ACA or commercial health plans (preferred).
  • Experience working in a fast-paced, collaborative environment (preferred).
  • Must reside in one of the approved states listed in the posting.

Benefits

  • Base salary of $264,000-$346,000 per year.
  • Unlimited vacation program.
  • Company equity grants.
  • Annual performance bonuses.
  • Medical, dental, and vision benefits.
  • 11 paid holidays, paid sick time, and paid parental leave.
  • 401(k) plan participation.
  • Life and disability insurance.
  • Paid wellness time and reimbursements.

Interested in this position?

Apply directly on the company website

Apply Now

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