Senior Analyst, Regulatory Affairs

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Legal & ComplianceOtherRegulatory AffairsRegulatory Analyst

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Quick Summary

Key Responsibilities

Serve as the subject matter expert on assigned state and federal policy for provider dispute and IDR legislative matters,

Requirements Summary

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.

Technical Tools

Legal & ComplianceOtherRegulatory AffairsRegulatory Analyst

Hi, we're Oscar. We're hiring an Senior Analyst, Regulatory Affairs to join our Regulatory Affairs.

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

~1 min read

The Senior Analyst, Regulatory Affairs is a contributor and owner of mission critical workflows to maintain and operate the Independent Dispute Resolution process. In assigned jurisdictions, you will intake disputes from providers, engage in negotiation with business unit support, perform all relevant admin functions, and ultimately prepare arbitration briefing where needed. You will keep tabs on developments to No Surprises Act policies and support the Regulatory Affairs function in serving as an enterprise wide resource on public policy and IDR trends.

You will report into the Director, Regulatory Affairs.

Responsibilities

~1 min read

→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

Requirements

~1 min read

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.

Nice to Have

~2 min read

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.

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.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

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.

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