All roles

[Remote] Senior Analyst, Regulatory Affairs

Remote · USA Full-time New today

Note: The job is a remote job and is open to candidates in USA. Oscar Health is a health insurance company built around a full stack technology platform focused on serving its members. The Senior Analyst, Regulatory Affairs will manage mission-critical workflows related to the Independent Dispute Resolution process, engaging in negotiations and ensuring compliance with relevant policies and regulations.

Responsibilities

  • Serve as the subject matter expert on assigned state and federal policy for provider dispute and IDR legislative matters, while applying newly proposed and effective laws and regulations to processes as appropriate in assigned jurisdictions
  • With support from team leads, prepare clear, concise, user friendly briefing based upon case needs
  • Deliver multiple, simultaneous and diverse assignments while adhering to strict deadlines and managing competing priorities in a fast-paced environment
  • Serve as a point of contact for provider negotiations relating to IDR
  • Perform eligibility reviews of disputed claims to ensure all cases are routed to the appropriate venue
  • Manage the end-to-end administrative lifecycle of each dispute by maintaining real-time updates on project management boards, gathering and redacting member documentation, and uploading supporting evidence to the appropriate portal stages within set regulatory deadlines
  • Independently manage workload and related dependencies in compliance with required regulatory timelines
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Skills

  • Bachelor's degree in the humanities, legal studies, political science, public policy, public administration, public health or other relevant field or a combination of education and experience
  • 2+ years of experience with cross-functional project management experience
  • 2+ years of experience communicating with and presenting information to internal and external stakeholders
  • 2+ years of experience distilling complex issues into digestible action items, for audiences at varying levels of seniority
  • 2+ years of experience legislative tracking software, and Google Workspace
  • Experience working with Independent Dispute Resolution is a huge plus
  • Experience working in personal injury law firms or as a paralegal
  • Familiarity with the Affordable Care Act and the No Surprises Act
  • Experience with the individual and/or group markets
  • Experience working with attorneys and internal stakeholders

Benefits

  • Employee benefits
  • Participation in Oscar's unlimited vacation program
  • Annual performance bonuses
  • Medical, dental, and vision benefits
  • 11 paid holidays
  • Paid sick time
  • Paid parental leave
  • 401(k) plan participation
  • Life and disability insurance
  • Paid wellness time and reimbursements

Company Overview

  • Oscar is a health insurance company that offers individual and family plans, medicare advantages, and small group products. It was founded in 2012, and is headquartered in New York, New York, USA, with a workforce of 1001-5000 employees. Its website is http://www.hioscar.com.
  • Apply To This Job

    Related roles

    [Remote] Security Engineer, Product

    Remote · USA Full-time

    [Remote] Staff Developer, Growth

    Remote · USA Full-time

    [Remote] Senior People Systems & Integrations Analyst

    Remote · USA Full-time

    [Remote] Global Enterprise Account Executive

    Remote · USA Full-time

    [Remote] Software Engineer, Code Platform

    Remote · USA Full-time

    [Remote] Sr Software Engineer

    Remote · USA Full-time

    [Remote] Commercial Business Development Executive

    Remote · USA Full-time

    [Remote] Recruiting Operations Associate, GTM (Contract)

    Remote · USA Full-time

    [Remote] Senior Manager, Partner Marketing - AMER

    Remote · USA Full-time

    [Remote] Lead GRC Analyst

    Remote · USA Full-time

    Experienced Customer Support Engineer I Intern – AI-Driven Payments and Fintech Innovation

    Remote · USA Full-time

    Experienced Virtual Data Entry Specialist | Part-Time | Remote Job | $25-$35/hr

    Remote · USA Full-time

    Remote Virtual Customer Care Professional – World-Class Financial Services Support Specialist

    Remote · USA Full-time

    IT Technical Support Specialist – Remote Data Entry & Desktop Support Professional

    Remote · USA Full-time

    CDQI Nurse Specialist - Part Time - Remote at Datavant Honolulu, HI

    Remote · USA Full-time

    Full Stack Software Engineer - Billing Team

    Remote · USA Full-time

    Workday Payroll, Absence and Time Tracking Consultant - Global AMS (Application Managed Services)

    Remote · USA Full-time

    Experienced Part-Time Remote Customer Support Specialist – Delivering Exceptional Apple User Experiences

    Remote · USA Full-time

    Experienced Cloud Representative - Inbound, Marketing Response Center

    Remote · USA Full-time

    JR - Graphic Designer

    Remote · USA Full-time