Demo

Associate, UM Regulatory Operations

Oscar Health
New York, NY Remote Full Time
POSTED ON 4/1/2025
AVAILABLE BEFORE 5/31/2025

Hi, we're Oscar. We're hiring a Associate, UM Regulatory Operations to join our 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

You will work cross functionally with business and technical Oscar stakeholders and representing the needs and interests of the department in company wide strategic initiatives and in solving business problems related to internal processes. You will lead the design, optimization, and implementation of processes and improvements to operations to support achieving organizational goals. You will collect and document business requirements, building and managing project plans, documenting key project decisions, managing project governance, applying frameworks, analyzing data, and developing and communicating risk mitigation strategies across different initiatives and stakeholders at the same time.

You will report to the Manager, UM Regulatory Operations.

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, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, 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. #LI-Remote

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

  • Lead the end-to-end management of cross-functional implementations/projects, including project plan creation, stakeholder engagement, managing cross-functional relationships to drive collaboration, edge case mitigation, and on-time completion.
  • Evaluate overall departmental performance by creating, gathering, analyzing and interpreting data and metrics and assisting in development of departmental metrics and implementation of mitigation strategies
  • Collaboratively works with all relevant internal and external stakeholder groups to formulate proactive implementation, communications, and program strategies for successful change management and risk mitigation initiatives
  • Mentor team members and promotes colleagues' growth and professional development
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Qualifications

  • 3 years of work experience in Utilization Management operations, health insurance, and/or consulting
  • 2 years experience in Mental Health Parity (MHPAEA), state market conduct exams, audits, NCQA, and other filings.
  • 2 years of experience with end to end project management
  • 2 years of experience in regulatory implementation and compliance
  • 2 years of experience in designing and improving workflows as well as standing up accompanying operating and technical procedures
  • A bachelor's degree or 3 years commensurate experience

Bonus Points

  • Bachelor's degree in Business Administration, or other related field
  • 2 years of experience using data software such as Excel, Google Sheets, SQL, Python or other data analytics tools
  • Experience with process improvement methodologies such as Lean, Six Sigma and/or Theory of constraints

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 (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 Notice to Job Applicants.

Salary : $88,560 - $116,235

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