Note: The job is a remote job and is open to candidates in USA. Oscar Health is a health insurance company built around a full stack technology platform focused on serving its members. The Senior Analyst, Regulatory Affairs will manage mission-critical workflows related to the Independent Dispute Resolution process, engaging in negotiations and ensuring compliance with relevant policies and regulations.
Responsibilities
- 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
Skills
- 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
- 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
Benefits
- Employee benefits
- Participation in Oscar's unlimited vacation program
- Annual performance bonuses
- Medical, dental, and vision benefits
- 11 paid holidays
- Paid sick time
- Paid parental leave
- 401(k) plan participation
- Life and disability insurance
- Paid wellness time and reimbursements
Company Overview