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Oscar logo
Oscar

Award-winning recruitment consultancy; delivering talent across Tech, Digital, Life-Sciences, Energy & Construction

Associate, UM Regulatory Operations

Location

Illinois + 5 moreAll locations: Illinois | Kentucky | Minnesota | Pennsylvania | Texas | Utah

Posted

60 days ago

Salary

$87.2K - $118.4K / year

Seniority

Mid Level

Bachelor Degree3 yrs expEnglish

Job Description

Associate, UM Regulatory Operations

Oscar

• Lead the end-to-end management of cross-functional implementations/projects, including project plan creation, stakeholder engagement, managing cross-functional relationships to drive collaboration, edge case mitigation, and on-time completion • Evaluate overall departmental performance by creating, gathering, analyzing and interpreting data and metrics as well as assisting in development of departmental metrics and implementation of mitigation strategies • Collaboratively works with all relevant internal and external stakeholder groups to interpret and apply new and evolving regulations, ensuring consistent understanding and accurate implementation across UM operations. • Coordinate regulatory request management for the UM department, including market conduct exams, URA filings, license renewals, and Mental Health Parity (MHPAEA) compliance. • Coordinates NCQA deliverables for UM standards • Evaluates and drafts UM policy and procedures ensuring compliance within the UM program • Mentor team members and promotes colleagues' growth and professional development • Compliance with all applicable laws and regulations • Other duties as assigned

Job Requirements

  • A bachelor's degree or 3+ years commensurate experience
  • 3+ years of work experience in healthcare Utilization Management operations, health insurance, and/or related field
  • 2+ years of experience supporting regulatory compliance activities, including Mental Health Parity (MHPAEA), market conduct exams, license renewals, NCQA surveys/accreditation, and other regulatory filings
  • 2+ years of experience with end to end project management or process improvement initiatives
  • 2+ years of experience in regulatory implementation and compliance
  • 2+ years of experience in designing and improving workflows as well as standing up accompanying operating and technical procedures
  • Bonus points:
  • 2+ years of experience using data software such as Excel, Microsoft Office, Google Sheets, GSuite
  • Experience collaborating with legal, compliance, and cross-functional teams
  • Experience with process improvement methodologies such as Lean, Six Sigma and/or Theory of constraints

Benefits

  • Employee benefits
  • Participation in Oscar's unlimited vacation program
  • Annual performance bonuses

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