Associate, Compliance Audit and Monitoring

Hi, we're Oscar. We're hiring an Associate, Compliance Audit and Monitoring to join our Compliance Audit and Monitoring team.

Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

The Associate, Compliance Audit and Monitoring supports our compliance program and activities. You will help develop all compliance program activities to ensure understanding of healthcare regulatory requirements. You will assess business unit compliance to laws, regulations, standards, and their policies and procedures by conducting audit and monitoring activities.

You will report to the Manager, Compliance Audit & Monitoring.

Work Location:

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.

If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.

You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change.

Pay Transparency:

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $98,400 - $129,150 per year. The base pay for this role in all other locations is: $88,560 - $116,235 per year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program and annual performance bonuses.

Responsibilities

• Help create a risk-based audit and monitoring plan for the healthcare organization.
• Analyze healthcare regulations, including HIPAA, Medicare, and Medicaid regulations to ensure compliance.
• Conduct assigned audits based on departmental audit plans.
• Collaborate with business units to understand their business operations and test their compliance with regulations.
• Evaluate compliance effectiveness and identify areas for improvement.
• Draft and complete accurate audit reports, ensuring that the audit findings and conclusions are communicated to the business unit.
• Help identify compliance gaps and risks, and contribute to the development of proactive strategies to address them.
• Help maintain compliance policies, procedures, and controls with regulatory requirements.
• Provide regular updates to leadership on compliance audit and monitoring activities and recommendations.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Qualifications

• Bachelor’s Degree or equivalent work experience
• 2+ years experience working in health care or related field
• 2+ years experience in health plan compliance
• 2+ years driving compliance with regulatory and accreditation audit/policy requirements
• 2+ years experience working with regulation and translating into operational procedures
• 2+ years experience

Bonus Points

• Certification in Healthcare Compliance (CHC), Certified Compliance and Ethics Professional CCEP, or similar
• Fluency with State DOI audit and/or reporting obligations
• State DOI audit management experience
• Experience in a startup and/or health tech environment
• Experience in a TPA setting

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives..

Pay Transparency:

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.

Full-time employees are eligible for benefits including: 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.

Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([email protected]) to make the need for an accommodation known.