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Oscar Health // health insurance
 
New York City, United States    Posted: Thursday, June 10, 2021
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. Were hiring Regional Medical Director for our Northeast Region.

Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 & headquartered in New York City. Our goal is to make health insurance simple, transparent, & human. We need your help to do so.

We're looking for an experienced physician to provide clinical leadership as a Regional Medical Director to support our continued expansion.   As an Oscar Regional Medical Director, you will have oversight responsibility for the medical management, quality improvement & clinical regulatory programs in your region.  You will also have the opportunity to take ownership responsibility for core clinical programs.  This is a full-time role.  Although the location of the role can be flexible, you should reside in an existing Oscar market. The role reports to Oscar's Senior Medical Director. 

Responsibilities:

Regional leadership

  • Establish yourself as the local clinical representative for internal stakeholders & liaison to external parties such as Oscars provider partners & clinical vendors.

  • Develop a strong working relationship with regulators in the state, including the Office of Insurance, & represent Oscar in clinical matters & audits.

  • Establish oversight responsibility for clinical functions in your region, including medical management & quality improvement, & interact cross functionally with both clinical & non-clinical counterparts to support their success.  

  • Track & analyze key utilization & clinical performance metrics in your region, including identifying & presenting trends to internal & external meetings & committees.

  • Serve as the internal & external point of accountability for escalated clinical issues in your region, including external utilization management appeals, member complaints & grievances & complex case management escalations. 

  • Develop familiarity with applicable regulatory & accreditation requirements as well as Oscar tools, teams & workflows in place to ensure we meet them.

  • Work collaboratively as a member of the market leadership team sharing responsibility for P & L.

  • Assist the data team to assimilate clinical facts & know-how into the data & financial models.

  • Support a total quality process to utilize best practices & continuously improve.

Corporate leadership

  • Provide clinical leadership within a core operational or business unit.

  • Support Oscars expansion efforts by obtaining necessary licensure & serving as a clinical representative with regulators. 

  • Demonstrate the highest level of professionalism, accountability, & service in your interactions with Oscar teammates, providers, & members.

  • Work with fellow regional medical directors, corporate leaders & the Chief Clinical Officer in setting the strategic medical management agenda.

  • Become a source of inspiration & subject matter expert for the build-out of technology & data tools.


 

Required experience & qualifications include:

  • Licensure: 

    • MD or DO with a current unrestricted license to practice medicine in the US.  Licensure in multiple Oscar states (dependent on region) preferred but not required; you should be willing to obtain additional state licenses, with Oscar's support. 

    • Board certified or eligible 

  • Experience: 

    • 3+ years in clinical practice 

    • 3+ years experience in the managed care industry or a provider system

    • Experience with presentations to regulators, provider systems, accreditation organizations & / or executive leadership

Bonus points if you have:

  • An advanced degree or certificate in business, or equivalent experience

  • Experience in a startup: understanding the pace & culture

  • Experience leading business units / clinical teams

  • Specialized expertise in some facet of clinical care: Psychiatry, Oncology, Cardiology, etc

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 & find both belonging & support. We're on a mission to change health care -- an experience made whole by our unique backgrounds & perspectives. We encourage our members to care for their whole selves, & 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, & volunteer opportunities.

Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicants disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) 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

 
 
 
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