Risk/Compliance Associate

Who you are

• Bachelor's Degree or equivalent work experience
• 1+ year experience in health plan compliance
• 2+ years experience with State DOI health insurance rules and regulations, CMS ACA rules and requirements, CMS requirements
• 2+ years experience managing high volume and complicated projects, keeping track of details, and staging work to deliver projects on time
• MLR, HCRA, CMS APTC audit experience
• Healthcare Finance background
• CHC, CCEC, 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

What the job involves

• We're hiring an Associate, Risk / Compliance to join our Compliance team
• The Associate, Risk / Compliance ensures that Oscar complies with industry specifications, standards, regulations, and laws. You will review operational practices, create and enforce procedures, and perform regulatory reviews. You will ensure and enforce compliance where required throughout the facility to ensure complete compliance in all areas of the business
• You will report into the Manager, Regulatory Audit Compliance
• Partner with all relevant departments to make sure current compliance levels
• Provide training to team members regarding regulatory compliance
• Ensure that all team members are aware of the procedures to be followed to follow compliance requirements
• Develop and implement compliance improvement plans where required
• Delegate tasks to other departments to bring compliance levels up
• Develop reports, to the governing body
• Assist Regulatory Authorities with completing site visits and external audits
• Prepare for, and conduct audits alongside external authorities
• Conduct regular audits in all required areas to ascertain compliance levels
• Compliance with all applicable laws and regulations
• Other duties as assigned