About the role
The Associate Director, Corporate Compliance is responsible for training, investigating, monitoring, and enforcing, when necessary, programs, policies, and practices to ensure all applicable operational functions are in compliance with federal, state and local regulatory requirements. The Associate Director manages compliance efforts for Oscar's licensed entities delivering Qualified Health Plans (QHPs) in the individual and small group markets. You will work with leadership and the larger Compliance team servicing Oscar and advising on how best to service its third-party QHP clients. You will use as a foundation for a robust and best in class compliance program including, but not limited to, the seven elements of an effective compliance program as published by the Office of the Inspector General (OIG). You will partner with operational leaders to identify compliance risk, implement corrective action plans, and promote a culture of integrity and excellence across the organization.
Responsibilities
- Lead, mentor, and support the Compliance team across all lines of business, encouraging professional development and advancing institutional compliance knowledge.
- Support the design, implementation, and continuous improvement of the corporate compliance program to promote an organizational culture of responsibility and accountability.
- Monitor and interpret federal and state regulations to lead business strategies that exceed industry standards for insurers, tech innovators, and public companies.
- Lead compliance investigations to assess adherence to obligations, and oversee the development, and monitoring of effective Corrective Action Plans.
- Develop and manage comprehensive compliance training programs throughout the entire organization.
- Produce and deliver clear, actionable compliance reports tailored for all organizational levels, including executive leadership and external regulatory bodies.
- Partner with Risk and Controls to manage regulatory risk sustainably while deploying scalable compliance functions that support Oscar's technology, strategic partners, and business growth.
- Lead the Compliance team in regulatory implementations and monitoring.
- TEFCA subject matter expert
- Compliance with all applicable laws and regulations
Requirements
- 7+ years' experience in a healthcare compliance setting, specifically in healthcare compliance, regulatory affairs, or other related experience.
- 5+ years' experience in managing effective Compliance teams.
- 5+ Experience applying state and federal health insurance statutes, regulations, marketplace, and MA requirements to meet reporting and audit obligations