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Associate, Utilization Management Regulatory Operations

Oscar HealthTempe, Arizona, United States
Hybrid Full-time $87.2K/yr - $118.4K/yr

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Experience Level

Experience

Qualifications

We are looking for a proactive and detail-oriented individual with strong project management skills. The ideal candidate should possess excellent communication abilities, a keen analytical mindset, and the capacity to work collaboratively across departments. Familiarity with regulatory requirements in the health insurance sector is a plus.

About the job

Oscar Health is hiring an Associate for the Utilization Management (UM) Regulatory Operations team in Tempe, Arizona. Since 2012, Oscar has focused on technology-driven health insurance and member-first care.

Role Overview

This Associate role centers on supporting UM Regulatory Operations by working with both business and technical partners. The position involves representing the department on strategic projects, gathering and documenting requirements, managing project plans, making decisions, and developing risk mitigation strategies. Managing several initiatives at once is a key part of the job.

This position reports to the Senior Manager of UM Regulatory Operations.

Location and Schedule

This is a hybrid role based in Oscar’s Tempe, Arizona office. Three days per week in the office are required. Thursdays are mandatory in-office days for team meetings. The other two in-office days can be chosen based on personal preference and team needs.

Compensation and Benefits

The annual base salary for this position ranges from $87,188 to $118,434. Oscar offers employee benefits, eligibility for annual performance bonuses, and participation in an unlimited vacation program.

Key Responsibilities

  • Manage cross-functional projects, ensuring deadlines are met and teams work together effectively.
  • Collect, analyze, and interpret data to assess departmental performance.
  • Collaborate with internal and external partners to interpret and implement changing regulations within UM operations.
  • Handle regulatory requests for the UM department, including market conduct exams, URA filings, license renewals, and Mental Health Parity compliance.
  • Coordinate NCQA deliverables related to UM standards.
  • Draft and review UM policies and procedures to ensure compliance.

About Oscar Health

Oscar Health is pioneering the health insurance landscape by leveraging a full-stack technology platform that prioritizes member care. Our mission is to create a health insurance experience that feels like having a trusted doctor in the family. We are dedicated to innovation, transparency, and providing exceptional service to our members.

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