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Oscar Health // health insurance
 
Los Angeles, CA    Posted: Wednesday, April 01, 2020
 
   
 
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JOB DETAILS
 

Summary

At Oscar, we work hard to provide the kind of health insurance we would want for ourselves. This means that we get to be creative & to build an excellent health insurer from the ground up. Weve brought together leaders from top technology & healthcare companies to create a talented team, all of whom are passionate about using technology, data, & design to deliver a better healthcare experience.

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 utilize your behavioral health expertise to define & drive Oscars future behavioral health strategy. 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.

More specifically, success in this role will require you to:

Corporate leadership:

  • Provide clinical leadership for behavioral health strategic initiatives & care management.
  • Develop innovative models, including payment models, integrated care models, & virtual care models, to support Oscars behavioral health strategy.
  • 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.

Locoregional 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.

Required experience & qualifications include:

    • Licensure:
      • MD or DO with a current unrestricted license to practice medicine in the US & specifically in California.
        • 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 in psychiatry
    • 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
  • Professional skills / attributes:
    • Influencer - able to move people without formal reporting structure
    • Excellent communication - written & spoken
    • Comfortable working with & speaking about technology
    • A passion for healthcare transformation that generates excitement with regulators & partners
    • Understanding of managed care regulatory structure & processes
    • Detail-oriented, flexible, & able to work autonomously with little supervision

Bonus points if you have:

    1. Experience with behavioral health integration
    2. An advanced degree or certificate in business, or equivalent experience
    3. Experience in a startup: understanding the pace & culture
    4. Experience leading business units / clinical teams

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we work to cultivate an environment where exceptional people can be their most authentic selves & find both belonging & support. We're on a mission to change healthcare -- an experience made whole by your unique background & perspectives.

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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