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Hi, we're Oscar. We're hiring an Associate Auditor, Delegation Audit to join our Compliance Audit & Monitoring team.

Oscar is the first health insurance company built around a full stack technology platform and a 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.

< class="h3">About the role

The Compliance Audit and Monitoring unit ensures that Oscar and its partners demonstrate their adherence to applicable laws, regulations, and rules – and that their own activities to ensure compliance are validated. Sitting within the Compliance team that supports and oversees Oscar's tech platform, called "+Oscar" (i.e., the entity that provides management services to Oscar's own insurance companies, and to its clients and strategic partners), the Compliance Audit and Monitoring unit works with all operational teams and delegates.

As an Associate within the Compliance Audit and Monitoring unit, specifically the Delegation Audit team, you will play an important role in leading the efforts to conduct pre-delegation, annual delegation, and credentialing audit assessments. You will lead audit assessments and monitoring activities of contracted delegated and credentialing providers. You will also support efforts to ensure the performance of delegates are monitored and measured on a periodic basis. Additionally, you will work with the Senior Manager, Compliance Audit and Monitoring to participate and help perform compliance audits of +Oscar's operations, and compiling the resulting reports. In this work, you will work with the full array of operational activities at +Oscar, in Oscar's licensed insurance entities, and among those delegates that provide services on Oscar's behalf.

You will report to the Director of Strategy.

This is a remote / work-from-home role. You must reside in one of the following states: Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $96,000 - $126,000 per year. The base pay for this role in all other locations is: $86,400 - $113,400 per year. You are also eligible for employee benefits and annual performance bonuses.

< class="h3">Responsibilities

• Support the drafting, updating, and enforcing approved procedures for the Compliance Audit and Monitoring team.
• Support efforts to plan and maintain audit schedule on an annual basis.
• Build independent testing to conduct pre-delegation, annual delegation and credentialing audit assessments for compliance with State and Federal contractual compliance (i.e., CMS) and accreditation standards (i.e., NCQA).
• Ensure audit assessments are conducted promptly and the necessary audit tools are developed with the appropriate regulatory and compliance indicators and assess the designated entity.
• During the audit assessments, identify and assess main risks and controls associated with the delegated functions to ensure areas of noncompliance are identified and appropriate corrective actions are implemented and reporting activities for internal committees and regulatory agencies are communicated promptly.
• Build and document audit work papers following Oscar's Compliance Audit Policy and Procedures.
• Support programmatic efforts, and lead efforts within the context of inidual audits, to ensure appropriate interface and coordination with other departments to achieve audit goals and ensure compliance.
• Develop communication mechanisms at multiple levels internal and external to Oscar. Prepare accurate and concise, and executive ready quarterly audit/quality reports for presentation to delegation oversight committees and subcommittees (i.e., Corporate Compliance Committee)

< class="h3">Qualifications

• 3+ years of experience in audit, compliance, oversight or healthcare with a focus in areas of delegation or credentialing that is demonstrated through one or a combination of the following: work experience, training.
• Bachelor's Degree in a related field or equivalent experience

< class="h3">Bonus Points

• Fluency with State DOI audit and reporting obligations
• Previous business consulting experience working with a professional services firm or similar role within an organization where there is the requirement to work collaboratively across multiple departmental areas.
• Experience in a startup and health tech environment

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This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. 

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, paid holidays, paid vacation and sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

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 ([email protected]) to make the need for an accommodation known.

To protect the health and safety of our employees, we require any employee conducting in-person work* to be fully vaccinated against COVID-19 by their start date. If you are unable to be vaccinated due to medical or protected religious reasons, please reach out to our Benefits team at [email protected] to submit an accommodations request.

*Note: In-person work includes: employees required to work from our offices, employees conducting sales work in the field and employees conducting at-home or in-person visits with members.