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Health Insurance

Manager, Regulatory Reporting

New York, NYHybridFull Time$106,812–$140,190 /yrPosted 2 months agoVisa sponsorship available

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Required skills

  • HIPAA
  • Medicare
  • ACA
  • Medicaid
  • CHC
  • CCEP
  • TPA

Nice to have

  • start-up
  • health tech

Role summary

Oscar is seeking a Manager, Regulatory Reporting to join its Compliance team in New York City. This role oversees compliance programs, ensuring adherence to healthcare regulations like HIPAA, Medicare, ACA, and Medicaid. Responsibilities include leading the regulatory reporting team, coordinating audits, developing reporting processes, and providing training. The position requires a hybrid work schedule with 3 days in the office per week. Oscar is a technology-driven health insurance company focused on member service.

Hi, we're Oscar. We're hiring a Manager, Regulatory Reporting to join our Compliance team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless 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 Manager, Regulatory Reporting manages Oscar's compliance programs and activities (i.e. regulatory). You will be responsible for overseeing the development, implementation, and management of all compliance programs to align with healthcare regulatory requirements. Additionally, you will assess compliance, alignment, and execution from multiple perspectives, including training material, standard operating procedures, business practices, and external communication.

You will report into the Director, Regulatory Audit & Reporting.

Work Location: This position is based in our New York City office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid

Pay Transparency: The base pay for this role is: $106,812 - $140,190 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

  • Ensure compliance with healthcare regulations, including HIPAA, Medicare, Affordable Care Act (ACA), and Medicaid.
  • Lead the regulatory reporting team, providing guidance, direction, and mentorship to ensure successful implementation and timely execution of regulatory reporting submissions
  • Coordinate and respond to data submission requests for internal and external audits
  • Develop dashboards and inventory processing method to ensure accuracy of regulatory reporting inventory
  • Collaborate with internal business leaders to improve end-to-end reporting process
  • Direct teams to meet submission timelines
  • Review technical documents for accuracy and quality
  • Proactive problem-solving and risk mitigation
  • Develop relationships with departmental leaders to understand business operations, identify areas of risk, and provide guidance on internal control design and implementation.
  • Provide regular updates to executive management and the Board of Directors including, but not limited to, developing and delivering reports, presentations, and memoranda.
  • Provide training, education, and communication to the enterprise regarding compliance topics and industry best practices.
  • Ensure that all teams are aware of, and complying with, the procedures to follow compliance requirements.
  • Delegate tasks and responsibilities effectively to departmental leads to ensure timely compliance actions.
  • Develop and implement compliance improvement plans where required.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

    • Requirements:

  • Bachelor's degree or commensurate work experience
  • 5+ years payer experience
  • 3+ years in leading direct reports and teams
  • 3+ years experience working in health care or related field with Policies & Procedures
  • 3+ years driving compliance with regulatory and accreditation audit/policy requirements
  • 3+ years experience working with regulations and translating into operational procedures
  • 3+ years experience managing several critical, external facing, deliverables simultaneously
  • 3+ years experience / background in a fast-paced operations environment
  • 3+ years experience in implementation, program building, and maintenance

    • Bonus points:

  • Certification in Healthcare Compliance (CHC), Certified Compliance and Ethics Professional (CCEP), or similar
  • Fluency with State Department of Insurance (DOI) audit and/or reporting obligations
  • State DOI audit management experience
  • Experience in a start-up and/or health tech environment
  • Experience in a Third Party Administrator (TPA) setting

    • This is an authentic Oscar Health job opportunity.

    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.

    Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

    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 (accommodations@hioscar.com) to make the need for an accommodation known.

    California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy.

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