Associate, Claims Regulatory Operations

September 20

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💰 $140M Private Equity Round on 2020-12

Description

• The Associate, Claims Regulatory Operations supports compliance within Provider Operations. • Conducts detailed data analysis and manages document reviews. • Oversees the delivery of Market Conduct Exam exhibits/narratives. • Ensures policies & procedures review process meets compliance requirements. • Collaborates with team members and senior leaders to improve processes.

Requirements

• Demonstrated understanding of Provider operations in the health payer industry. • 3+ years of relevant experience working with operational compliance, regulatory, and data analysis within Claims. • 3+ years experience designing and improving workflows • 3+ years experience working with regulatory bodies and Market Conduct Exams • Experience managing complicated business challenges: developing understanding, distilling and communicating that understanding to technical and non-technical audiences. • An academic and professional background in engineering, data, or healthcare • Knowledge management, training, or content development in operational settings • Process Improvement or Lean Six Sigma certification • Structured, systematic, and critical thinking • Strong verbal and written communications • 3+ years experience using data software (e.g. Excel, VGA, Macros, SQL and/or Python) to manipulate and analyze large data sets to solve business problems

Benefits

• Employee benefits • Participation in Oscar’s unlimited vacation program • Annual performance bonuses