Manager, Regulatory Complaints

Hi, we're Oscar. We're hiring a Manager, Regulatory Complaints 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 Manager, Regulatory Operations is responsible for managing the collaborative filing processes with cross-functional stakeholders, inclusive of conducting research and regulatory outreach. This role also oversees the alignment across submission documents, execution of executive signatures, and any required notarizations in submissions to CMS, SBEs, and State DOI’s, while managing the objection cycle through regulatory approval. This position works closely with internal Oscar teams and interfaces with our external federal and state regulators.

You will report into the Senior Manager, Regulatory Operations.

Work Location

This is a remote position, open to candidates who reside in: Arizona, California, 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 NY, NJ and CA is: $123,372 - $161,925 per year. The base pay for this role for all other locations is: $111,034 - $145,733 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

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.

Requirements

Bachelor's degree or commensurate experience

1+ years of SERFF and HIOS experience

Demonstrated project management skills

Bonus Points

Familiarity with ACA marketplace plans, rules and regulations

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At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.

Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

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Reasonable Accommodation

Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

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