Associate Director, Claims Compliance

Remote Leadership Role: Claims Compliance

In this remote leadership role, you drive claims compliance by guiding a team that handles regulatory inquiries and market conduct exams. You collaborate across Insurance Operations and with regulators to strengthen claims processes and regulatory performance. You translate strategic goals into actionable plans, overseeing KPIs and SLAs while shaping the program's direction. This position offers impact through improving compliance, working with cross-functional partners, and contributing to Oscar's mission to serve members with a tech-driven health insurance platform. A strong hook is the opportunity to transform regulatory ideas into scalable solutions within a growth-focused company.

Compensation / Benefits

• medical, dental, and vision benefits
• 11 paid holidays
• paid sick time
• paid parental leave
• 401(k) plan participation
• life and disability insurance

Responsibilities

• Lead and coordinate a team of claims analysts focused on regulatory compliance and external responses
• Oversee investigations of regulatory inquiries and development of formal responses
• Influence strategic direction with quantitative and qualitative inputs to improve compliance outcomes
• Translate department strategy into business plans to meet KPIs, targets, and SLAs
• Establish structures to achieve programmatic and departmental goals
• Supervise and develop managers and staff as needed
• Collaborate with other departments and inter-departmental operations on claims issues
• Engage with regulators and Oscar's legal, audit, and regulatory compliance teams
• Ensure adherence to applicable laws and regulations
• Manage cross-department initiatives to ensure timely results
• Provide coaching to improve processes and workflows

Key requirements

• 7+ years of experience in claims operations, insurance products, and regulatory language
• 5+ years of people management and team leadership
• Proven track record collaborating with regulatory agencies and understanding regulatory requirements
• Experience forming data-driven responses in uncertain environments

• leadership
• excellent communication
• cross-functional collaboration
• regulatory compliance expertise
• data-driven analysis
• ability to work with technical teams to define tooling and processes

American Statistical Association - ASA