Market Conduct / Delegation Oversight Associate

Oscar Health•Atlanta, GA

13d•Remote

About The Position

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 Associate, Delegate Oversight supports the enterprise's compliance program and activities. You will assist in the development of all compliance program activities to ensure understanding of healthcare regulatory requirements. You will assess business unit compliance to laws, regulations, standards, and their procedures by conducting audit and monitoring activities. You will report into the Sr. Manager, Compliance Audit and Monitoring. Work Location: This is a remote position, open to candidates who reside in: Atlanta, GA. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

Requirements

Bachelor's Degree or equivalent work experience
3+ years experience working in health care or related field
3+ years experience in health plan compliance
3+ years driving compliance with regulatory and accreditation audit/policy requirements
3+ years experience working with regulation and translating into operational procedures
3+ years experience / background in a fast-paced environment

Nice To Haves

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

Responsibilities

Help create a risk-based audit and monitoring plan for the healthcare organization.
Review healthcare regulations, including HIPAA, Medicare, and Medicaid regulations to ensure compliance.
Conduct assigned audits based on departmental audit plans.
Partner with teams to understand their business operations and test their compliance with regulations.
Evaluate compliance effectiveness and identify areas for improvement.
Draft and complete accurate audit reports, ensuring that the audit findings and conclusions are communicated to the business unit.
Help identify compliance gaps and risks, and contribute to the development of proactive strategies to address them.
Help maintain compliance policies, procedures, and controls with regulatory requirements.
Provide regular updates to leadership on compliance audit and monitoring activities and recommendations.
Compliance with all applicable laws and regulations
Other duties as assigned