Sr. Analyst, Regulatory Complaints
WFA Digital Insight
The demand for skilled regulatory complaint analysts has skyrocketed, with a 25% increase in job postings over the past year. As the healthcare industry continues to evolve, companies like Oscar are seeking talented professionals to navigate complex regulatory landscapes. With the rise of remote work, this role offers a unique opportunity to join a forward-thinking company and make a meaningful impact in the healthcare sector. Before applying, candidates should be prepared to demonstrate their expertise in regulatory compliance, analytical skills, and ability to work collaboratively in a remote environment.
Job Description
About the Role
The Sr. Analyst, Regulatory Complaints plays a critical role in Oscar's Compliance Team, serving as a key resource for regulators and internal stakeholders. This position is responsible for providing responses to potential concerns from State DOIs, partnering with internal business departments to resolve member and provider complaints, and identifying issues and trends. The successful candidate will be a strategic thinker, able to analyze complex regulatory issues, develop effective solutions, and communicate clearly with both internal and external stakeholders.As a member of the Compliance Team, the Sr. Analyst will report to the Sr. Manager, Regulatory Operations and will work closely with cross-functional teams to resolve complaints and develop relationships with regulators. This is a remote position, open to candidates residing in specific states, with the possibility of adapting to a hybrid work model in the future.
What You Will Do
- Research and resolve regulatory complaints in a timely and efficient manner
- Partner with internal business departments to resolve member and provider complaints
- Identify issues and trends related to regulatory complaints and develop strategies to prevent recurrence
- Develop and maintain relationships with state insurance regulators
- Collaborate with leadership to share trends and propose solutions to prevent future complaints
- Advise teammates on potential solutions to current regulatory complaints
- Ensure compliance with all applicable laws and regulations
- Stay up-to-date on changes in regulatory requirements and industry trends
- Develop and implement processes to improve complaint resolution and regulatory compliance
What We Are Looking For
- 3+ years of experience in health insurance customer service, claims, appeals, or regulatory teams
- 2+ years of experience working with regulators
- Strong analytical and problem-solving skills
- Excellent communication and interpersonal skills
- Ability to work in a fast-paced, dynamic environment
- Experience with individual market health insurance plans
- Knowledge of applicable laws and regulations related to health insurance
- Experience working cross-functionally with internal business partners
Nice to Have
- Experience resolving health insurance claims and appeals
- Familiarity with regulatory compliance software and tools
- Certification in regulatory compliance or a related field
Benefits and Perks
- Competitive base pay
- Eligibility for employee benefits, including medical, dental, and vision benefits
- 11 paid holidays and paid sick time
- Paid parental leave and 401(k) plan participation
- Life and disability insurance and paid wellness time and reimbursements
- Opportunities for professional growth and development
- Remote work arrangements with flexible scheduling
How to Stand Out
- Develop a strong understanding of regulatory compliance and the healthcare industry to stand out in the application process
- Showcase your analytical and problem-solving skills through specific examples and scenarios
- Highlight your experience working with regulators and internal stakeholders to demonstrate your ability to build strong relationships
- Prepare to discuss your knowledge of applicable laws and regulations related to health insurance
- Be prepared to walk through your process for resolving complex regulatory complaints and identifying areas for improvement
- Consider obtaining certification in regulatory compliance or a related field to enhance your qualifications
- Research Oscar's company culture and values to demonstrate your fit for the organization
This is a remote position listed on WFA Digital, the platform for professionals who work from anywhere. Browse more remote jobs across all categories.