Sr. Analyst, Regulatory Complaints

About the role

The Sr. Analyst, Regulatory Complaints is an important resource for regulators, with responsibility for providing responses to potential concerns from State DOIs. You will partner with internal business departments to resolve member and provider complaints, identify issues and trends, and provide written resolution to regulators. You will meaningfully contribute to the development of relationships with regulators, and will be a resource to their teammates in the resolution of complaints. You will report into the Sr. Manager, Regulatory Operations.

Work Location

This is a remote position, open to candidates who reside in: Arizona, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Virginia. 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. If you live within commutable distance to our New York City office (in Hudson Square) or our Tempe office (off the 101 at University Ave), you will be expected to come into the office at least three days each week. Otherwise, this is a remote / work-from-home role. 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 in the states of New Jersey and New York is: $38.22 - $50.16 per hour. The base pay for this role in all other locations is: $34.39 - $45.24 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities

• Research and resolution of Regulatory Complaints
• Support identification of escalated issues by using Oscar processes
• Partner with leadership to share trends related to complaints received while proposing solutions to prevent recurrence
• Advise teammates on potential solutions to current regulatory complaints
• Develop successful relationships with state insurance regulators
• Compliance with all applicable laws and regulations.

Requirements

• 3+ years of experience in health insurance customer service, claims, appeals, or Regulatory team
• 2+ years of experience working with regulators
• Bonus Points: Experience resolving health insurance claims and appeals, Experience with the individual market health insurance plans, Experience working cross-functionally with internal business partners