Description

You will build and oversee the Clinical Policy, Regulatory, and Compliance functions within Oscar Health's Office of Clinical Affairs, ensuring clinical operations meet healthcare laws and standards, developing regulatory policies, and advising senior leadership.

Requirements

• Active unrestricted MD or DO license
• 10+ years experience in healthcare or health insurance industry
• 5+ years experience in clinical policy compliance or clinical regulatory affairs
• 5+ years applying state and federal health insurance laws and regulations
• 5+ years team leadership and people development experience

Responsibilities

• Lead and grow the Clinical Policy Regulatory Affairs team
• Build and manage processes ensuring clinical policy compliance and quality
• Develop and maintain BIPs, SOPs, and clinical policy documents aligned with QMS
• Serve as regulatory compliance expert and maintain relationships with clinical teams
• Deliver executive briefings on regulatory and policy impacts