Senior Manager, Clinical Practice Compliance
Company: Oscar Health Insurance
Posted on: February 25, 2021
Senior Manager, Clinical Practice Compliance Hi, we're Oscar.
We're hiring a Senior Manager, Clinical Practice Compliance to join
our Oscar Medical Group team in our Texas location.-- Oscar is a
technology-driven, consumer-focused health insurance startup
founded in 2012 and headquartered in New York City. Our goal is to
make health insurance simple, transparent, and human. We need your
help to do so. About the role: Oscar Medical Group is looking for
an experienced clinical practice Compliance Sr Manager to support
the telehealth practice's growth and ensure that our members
continue to receive the high-quality care they deserve. You will
own the end-to-end Compliance and Oversight processes for our
providers.-- The Compliance Sr. Manager should have knowledge in
many areas, including business administration, clinical activities,
coding, billing, reimbursement, risk management, and strong
familiarity with the laws and regulations applicable to telehealth
practices. They must exercise good judgment, prioritize
thoughtfully, and - to foster the necessary culture - be
approachable. You will report into the Director, Practice
Transformation & Operations Responsibilities:
- Design and own the practice compliance and provider quality
processes, especially processes related to HIPAA and state-specific
regulations pertaining to telehealth.
- Design and build new processes/systems as needed for provider
entities' billing practices with respect to government payors.
- Support the provider entities' entry into new states and
markets by ensuring preparedness and compliance with applicable
clinical practice and telehealth regulations.
- Develop, coordinate, and if necessary conduct practice
compliance training programs for practice staff. Manage maintenance
and audit compliance training records--
- Develop policies and processes for reporting non-compliance
issues, including management of the compliance reporting process
for all persons associated with the practice.
- Track and maintain records related to compliance plans,
including audit documentation, training resources for practice
personnel and agents, screening results, reports of suspected or
actual noncompliance, investigations reports and records, and all
corrective action plans.
- Manage the practice compliance budget. Requirements:
- 6+ years' of relevant experience (e.g., provider-side
compliance, telehealth management, practice management, quality
- Experience with regulatory bodies and knowledge of HIPAA and
- Knowledge of telehealth, provider-side compliance, and a desire
to build a culture of compliance and ethics.
- Applicable health care and/or compliance certifications (e.g.,
AAPC/ CPPM, CPCO; HCCA/CHC; HTE/CCP; SCCE/CCEP)
- Managerial experience
- Experience with billing government payors, including Medicare
Advantage, and coordination of benefits
- Strong design to tackle the challenges (and opportunities)
posed by telemedicine/health Life at Oscar:-- 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. We encourage our members to care for their whole
selves, and we encourage our employees to do the same with
comprehensive medical benefits, generous paid-time off, paid
parental leave, retirement plans, company social events, stocked
kitchens, wellness programs, and volunteer opportunities.
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 (firstname.lastname@example.org)
to make the need for an accommodation known. Pay Transparency
Policy: Oscar ensures that you won't be discharged or discriminated
against based on whether you've inquired about, discussed, or
disclosed your pay. Read the full policy here . Oscar is an HMO
with a Medicare contract. Enrollment in Oscar depends on contract
renewal. *The Silver&Fit program is provided by American
Specialty Health Fitness, Inc., a subsidiary of American Specialty
Health Incorporated (ASH). Silver&Fit is a registered trademark
of ASH and used with permission herein. Other names or logos may be
trademarks of their respective owners.
Keywords: Oscar Health Insurance, Dallas , Senior Manager, Clinical Practice Compliance, Executive , Dallas, Texas
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