Regulatory Complaints Associate
Oscar Health
Job Overview
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Job Description
Regulatory Complaints Associate at Oscar Health
Hi, we're Oscar. We're hiring a Regulatory Complaints Associate to join our Regulatory team.
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
The Regulatory Complaints Associate is a key resource for regulators, with responsibility for providing key insight. This role will partner with internal business departments to resolve member and provider complaints, identify issues and trends, and provide written resolution to regulators. The Associate will play a key role in the development of relationships with regulators and will serve as a resource to their teammates in the resolution of complaints.
You will report into the Senior 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.
Pay Transparency: The base pay for this role in the states of New Jersey and New York is: $101,844 - $133,670 per year. The base pay for this role for all other locations is: $91,659 - $120,303 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.
Responsibilities
- Research and Resolution of Regulatory Complaints
- Supports identification of escalated issues by using Oscar systems and processes
- Partners with internal business teams and leadership to share trends related to complaints received while proposing solutions to prevent recurrence
- Advise teammates on potential solutions to current regulatory complaints
- Develop and maintain successful relationships with state insurance regulators
- Compliance with all applicable laws and regulations.
Requirements
- 4+ 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
Key skills/competency
- Regulatory Compliance
- Complaint Resolution
- Health Insurance
- Claims Management
- Appeals Process
- Stakeholder Relations
- Trend Analysis
- Problem Solving
- Customer Service
- Communication Skills
How to Get Hired at Oscar Health
- Research Oscar Health's culture: Study their mission, values, recent news, and employee testimonials on LinkedIn and Glassdoor.
- Tailor your resume for regulatory roles: Highlight experience in health insurance customer service, claims, appeals, and regulatory compliance to match the Regulatory Complaints Associate requirements.
- Prepare for behavioral interviews: Focus on demonstrating problem-solving, collaboration, and relationship-building skills relevant to regulatory interactions at Oscar Health.
- Showcase health insurance expertise: Emphasize your knowledge of health insurance claims, appeals, and regulatory frameworks to impress Oscar Health hiring managers.
- Network strategically: Connect with current and former Oscar Health employees on LinkedIn for insights and potential referrals.
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