Assistant Regional Clinical Director overseeing clinical operations for ABA services provided to individuals with Autism Spectrum Disorder. Leading BCBAs and driving quality and effectiveness across multiple states.
About the role
- Medical Director overseeing Clinical Policy and Regulatory Affairs at Oscar Health. Leading regulatory compliance and managing clinical operations for health insurance services.
Responsibilities
- Lead and grow the Clinical Policy & Regulatory Affairs team.
- Build and manage processes that ensure clinical policy compliance and quality.
- Develop and maintain BIPs, SOPs, and other clinical policy documents aligned with QMS.
- Serve as a regulatory compliance expert and maintain strong relationships with key clinical teams.
- Deliver executive briefings on regulatory and policy impacts.
- Advise the CMO and senior leaders on compliance risks and strategy.
- Support interactions with federal and state regulators (FDA, CMS, state DOI).
- Oversee the Clinical Coding Center of Excellence and clinical credentialing.
- Promote a culture of compliance through training and education.
- Collaborate effectively with stakeholders across the organization.
Requirements
- Active, unrestricted MD or DO license
- 10+ years of experience in healthcare or the health insurance industry
- 5+ years of experience in clinical policy compliance or clinical regulatory/government affairs
- 5+ years applying state and federal health insurance laws and regulations (Marketplace, MA, reporting, and audit requirements)
- 5+ years preparing and presenting reports to boards of directors
- 5+ years of team leadership and people development experience
Benefits
- employee benefits
- participation in Oscar's unlimited vacation program
- annual performance bonuses
- medical, dental, and vision benefits
- 11 paid holidays
- paid sick time
- paid parental leave
- 401(k) plan participation
- life and disability insurance
- paid wellness time and reimbursements
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