Manager, Regulatory Reporting

Oscar Health•Atlanta, GA

16h•$96,130 - $126,171•Remote

About The Position

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.

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

Nice To Haves

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

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