Hi, we're Oscar. We're hiring a Vice President, Clinical Affairs to join our Member Strategy & Operations team.
Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.
About the role
The Vice President, Clinical Affairs will be responsible for defining and driving member- and provider-facing clinical strategy and performance by partnering closely with senior leaders in both the Platform Operations and Service Operations arms of the Operations organization. Member-facing responsibilities will involve defining, delivering, and measuring clinical value for our members through our Clinical Care Team. Provider-facing responsibilities will include defining, delivering, and measuring clinical value through leadership of our UM program and clinical policy strategy. This role will additionally be responsible for partnering with Oscar Medical Group leaders (Oscar’s direct care delivery arm) to optimize and deploy Oscar’s virtual health strategy.
You will report to the Chief Medical Officer.
This is a remote / work-from-home role. You must reside in one of the following states: Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote
The base pay for this role is: $308,800 - $405,300 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.
Responsibilities
- Partner with operational and technology leadership to define and execute on a best-in-class member clinical support model, including clinical programming and case management services
- Partner with operational and technology leadership to define and execute on a best-in-class Utilization Management program, including clinical policy and prior authorization list strategy and development
- Participate in the insurance product development process to support clinical innovation in Oscar’s plan and product design
- Partner with Oscar’s care delivery arm (Oscar Medical Group) to optimize and deploy our virtual health program strategy
- Oversee and manage a team of clinical leaders
- Develop familiarity with applicable regulatory and accreditation requirements as well as Oscar tools, teams and workflows in place to ensure we meet them
- Work with fellow clinical leaders, corporate leaders, and the Chief Medical Officer in setting the strategic medical management and affordability agenda
- Demonstrate the highest level of professionalism, accountability, and service in your interactions with Oscar teammates, providers, and members
- Be a source of inspiration and subject matter expert for the build-out of tools, technology, and data models
- Compliance with all applicable laws and regulations
- Other duties as assigned
Qualifications
- Board certified or eligible MD or DO with a current unrestricted license to practice medicine in the US
- 15+ years of experience in the healthcare industry, including
- 3+ years in clinical practice
- 7+ years experience with managed care (payer or provider)
- 5+ years leading clinical departments
- Experience with presentations to regulators, provider systems, accreditation organizations and / or executive leadership.Experience leading business units / clinical teams
Bonus Points
- An advanced degree or certificate in business, or equivalent experience
- Experience in a startup: understanding the pace and culture
- Experience with Affordable Care Act insurance products
- Licensure in multiple Oscar states and/or willing to obtain additional state licenses, with Oscar's support.
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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..
Pay Transparency:
Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.
Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.
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 (accommodations@hioscar.com) to make the need for an accommodation known.