Manager, Regulatory Reporting

About the role

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. You will report into the Director, Regulatory Audit & Reporting.

Work Location

This position is based in our New York City office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule.

Pay

The base pay for this role is: $106,812 - $140,190 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

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 methods 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.
• Proactively solve problems and mitigate risks.
• 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 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.
• Comply with all applicable laws and regulations.
• Other duties as assigned.

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
• Bonus Points: 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

Benefits

You are eligible for employee 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.