[Remote] Manager, Regulatory Complaints
Note: The job is a remote job and is open to candidates in USA. Oscar Health is a health insurance company focused on serving members through a technology-driven platform. They are seeking a Manager, Regulatory Complaints to oversee the filing processes with regulatory bodies and manage collaborative efforts with internal and external stakeholders.
Responsibilities
- Ensure the accurate and timely submission of Oscar’s annual regulatory obligations
- Maintain a repository of internal procedural guides on filing obligations to support teams and retain institutional knowledge
- Help maintain and grow relationships with regulatory bodies in the states where Oscar operates
- Prepare, file, and secure approval and certification of Oscar’s insurance products through the annual Qualified Health Plan (QHP) filings application process (form, binder, rate, network) with state regulators, state exchanges, and Centers for Medicare & Medicaid Services (CMS)
- Compile and maintain filing deadlines for form, binder, rate, and network annual QHP submissions by state and lines of business
- Manage, train, provide feedback and assign responsibilities for direct reports to support their professional growth
- Oversee special filings, such as the quarterly (Rate & Benefits Information System) RBIS submission files to CMS to ensure risk adjustment data can be processed timely and/or provider and vendor contract filings
- Work independently under remote management, encouraging solid relationships with regulators and colleagues
- Compliance with all applicable laws and regulations
- Other duties as assigned
Skills
- Bachelor's degree or commensurate experience
- 1+ years of SERFF and HIOS experience
- Demonstrated project management skills
- Familiarity with ACA marketplace plans, rules and regulations
Benefits
- 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