Oscar Health

Director

• Lead the strategy, performance, and future readiness of Tier 1 and Tier 2 contact center operations across Member, Broker, and Provider channels
• Direct end-to-end Tier 1 and Tier 2 contact center operations across voice and digital channels
• Execute a multi-year strategy to scale service operations, build resilience, and future-proof contact center operations
• Lead a geographically distributed leadership organization and foster an inclusive, high-accountability remote culture
• Champion a human-centered service model combining automation, analytics, workflow design, and expert human support
• Establish performance frameworks covering SLAs, quality, accuracy, first-contact resolution, customer effort, and unit cost
• Leverage contact center analytics and customer journey trends to mitigate operational risk and prioritize initiatives
• Collaborate with internal and external partners to design scalable, compliant processes
• Drive workforce management and capacity planning
• Influence enterprise technology roadmaps, policies, and cross-functional processes
• Cultivate leadership talent through coaching, career pathing, and succession planning
• Oversee short- and long-term operating budgets
• Ensure adherence to financial controls, regulatory mandates, operational timeliness, and compliance standards
• Report to the Senior Director Member & Provider Programs
• Perform other duties as assigned

Senior Director – Member and Provider Services

Analyst

• Identify and conduct investigations into known or suspected Fraud, Waste, and Abuse with high autonomy
• Develop documentation to substantiate findings, including formal reports, graphs, audit logs, and other supporting documentation
• Meet targets through investigations and internal process improvements for FWA recoupments and savings
• Analyze prior cases to inform future identification of similar claims or cases and associated savings
• Help move from “pay-and-chase” to preventive edits and prepayment activity
• Participate in the development and presentation of FWA-related education for Oscar teams
• Comply with all applicable laws and regulations
• Perform other duties as assigned
• Report to the Investigations Manager, SIU

Senior Analyst, SIU Investigator

• Identify and conduct investigations into known or suspected fraud, waste, and abuse (FWA) with high autonomy
• Develop documentation to substantiate findings, including formal reports, graphs, audit logs, and other supporting documentation
• Meet targets through investigations and internal process improvements for FWA recoupments and savings
• Perform analysis on prior cases to inform future identification of similar claims or cases and associated savings
• Help move from “pay-and-chase” to preventive edits and prepayment activity
• Participate in the development and presentation of FWA-related education for Oscar teams
• Comply with all applicable laws and regulations
• Perform other duties as assigned
• Report to the Investigations Manager, SIU

General

• Support the design and execution of a network construction and support plan for a market / several markets with support from your manager.
• Meet defined metrics and SLAs including provider outreach and contract completion.
• Support overall contract negotiations, working with leaders to align on contracting strategies that bring new partners into the network.
• Work with senior analysts and management to support the identification, sourcing, and contracting efforts with providers in a region.
• Document and share provider feedback, objections, and questions to support continuous improvement of templates and processes.
• Comply with all applicable laws and regulations.
• Perform other duties as assigned.
• Report to the Manager, Network Contracting.

Network Contracting Specialist

Bilingual

• Deliver quality care to patients on Oscar's platforms via phone and video
• Serve as a supervising physician to Advanced Practice Providers
• Provide direct oversight and supervision of nurse practitioners and physician assistants within state-by-state regulations
• Provide medical care virtually by phone, video, and message in alignment with Oscar Medical Group guidelines, practices, and policies
• Collaborate with MAs, RNs, and other providers across service lines
• Comply with all applicable laws and regulations
• Perform other duties as assigned
• Report to the Director, Virtual Health Assessment

Bilingual Physician – Spanish/English

Account Manager

• Lead the end-to-end strategy, implementation, and ongoing management of the Risk Adjustment Provider Partnerships program, including program plans, milestones, operating rhythms, risks, and success metrics
• Partner with Network, Market, Legal/Contracting, Risk Adjustment, and Data Science teams to incorporate risk-adjustment requirements and enablement approaches into provider agreements and operating models
• Establish and maintain operational relationships with provider organizations; drive alignment on performance expectations, improvement opportunities, and mutual commitments
• Analyze provider performance, workflows, and documentation/coding trends to identify causes, prioritize opportunities, and develop targeted mitigation and improvement plans
• Lead cross-functional implementation of provider-specific interventions; manage dependencies, resolve issues, and escalate decisions or risks that threaten outcomes or timelines
• Develop and communicate performance reporting, program insights, risks, and recommendations to internal leaders and external partners
• Build scalable provider education, engagement, and incentive approaches that improve adoption of risk-adjustment best practices
• Ensure compliance with all applicable laws and regulations
• Perform other duties as assigned
• Report to the Director, Risk Adjustment Prospective and Planning

Manager, Risk Adjustment, Provider Partnerships

Nurse

• Perform quality audits on clinical documentation for clinicians from a variety of clinical departments
• Develop audit surveys and rubrics supporting evidence-based clinical decision making, department workflows, and regulatory accreditation requirements
• Pull clinician and provider cases for auditing and track results in department systems
• Support organizational readiness and preparation for NCQA and other regulatory audits
• Perform delegate oversight audits, write audit result summary reports, and present findings to stakeholders and delegates
• Collaborate with leadership to develop corrective action plans addressing identified gaps
• Provide 1:1 feedback and coaching to front-line staff and leaders regarding workflows and audit requirements
• Develop training tools on quality best practices, audit standards, and related topics
• Collaborate with leadership and stakeholders on audit trends, process changes, and training development
• Deliver quality-oriented presentations and aggregate quality data to report performance trends
• Participate in audit calibration sessions and interrater reliability processes
• Comply with applicable laws and regulations
• Perform other duties as assigned

Senior Clinical Quality Nurse

Growth Marketing

• Lead development of new insurance product concepts and health solutions, including industry-targeted solutions, employer-subsidized offerings, and ICHRA products
• Translate enterprise and product strategy into early-stage designs, value propositions, and business cases
• Identify opportunities based on member needs, health disparities, employer demand, and market trends
• Promote concept refinement toward scalable, market-ready solutions
• Incorporate employer-subsidized and hybrid market opportunities into the innovation pipeline and strategic roadmap
• Analyze employer-subsidized insurance solutions, including ICHRA-aligned and hybrid ACA/employer models
• Identify opportunities to expand into employer-adjacent markets through partnerships with employers, brokers, and third-party platforms
• Design flexible product constructs that allow employer contributions while maintaining QHP compliance and scalability
• Evaluate go-to-market strategies for employer-targeted offerings
• Interpret market, competitive, and member analysis to inform innovation priorities
• Support opportunity sizing and business case inputs for new concepts
• Define right-to-win and differentiation strategies at market and segment levels
• Analyze employer market dynamics, broker influence, and distribution channel shifts
• Partner with product design, clinical, network, actuarial, corporate strategy, and growth teams
• Coordinate inputs and timelines from brainstorming through pilot and launch
• Partner with Sales, Broker Strategy, Market Leadership, and Growth teams on employer-facing solution design and growth strategies
• Support documentation and partner agreement efforts
• Support pilot execution and early-stage programs
• Track performance, gather insights, and summarize findings
• Recommend whether to refine, pivot, or discontinue product concepts
• Lead teams to develop requirements and support implementation
• Ensure compliance with applicable laws and regulations
• Perform other assigned responsibilities

Senior Manager, Employer Subsidized – New Growth Platforms

Insurance

• Develop insurance plan designs, including benefits, cost-sharing, and network structures
• Translate strategic direction and regulatory requirements into detailed, executable benefit configurations
• Ensure plan designs are reflected across internal systems and regulatory filings
• Partner with actuarial, regulatory, and compliance teams to validate benefit structures and cost-sharing agreements
• Support the product lifecycle from design through filing, implementation, and launch readiness
• Maintain operating rhythms across design and filing cycles, ensuring timelines, dependencies, and deliverables are met
• Improve process optimization and standardization across markets
• Lead continuous improvement efforts across product design and filing workflows
• Perform QA across plan designs, filings, and system configurations
• Identify and escalate inconsistencies or risks in design and execution
• Coordinate across partners to ensure accurate delivery of plans
• Support market, competitive, and regulatory analysis to inform plan design decisions
• Monitor plan performance and identify post-launch improvement opportunities
• Comply with all applicable laws and regulations
• Perform other duties as assigned

Manager, Insurance Product and Benefit Design

Manager

• Design and build dashboards, business-intelligence solutions, reusable metric logic, curated datasets, recurring analyses, and automation
• Use BI and data-development tools, including SQL, Python, or comparable code, to make medical cost, utilization, membership, risk, and financial performance transparent and actionable
• Translate stakeholder requirements into clear technical designs
• Translate approved actuarial and health-insurance methodologies into maintainable analytical solutions
• Preserve approved definitions, denominators, completion approaches, risk-adjustment conventions, and financial tie-outs
• Own complex solutions through requirements, prototyping, development, testing, user acceptance, deployment, monitoring, maintenance, and enhancement
• Make technical decisions balancing speed, usability, reuse, reliability, and maintainability
• Partner with Medical Economics, Actuarial, Finance, Data, BI, operational, and business stakeholders
• Define audiences and success measures, prioritize requirements, manage dependencies, and resolve tradeoffs
• Strengthen validation, code review, and documentation standards
• Ensure data freshness, cross-product and financial tie-outs; implement release controls and change management
• Develop plans to replace or retire legacy assets
• Identify appropriate opportunities for reusable AI-enabled workflows
• Review designs and code, guide matrixed contributors, and mentor colleagues
• Communicate completed solutions and insights through recurring operational and executive readouts
• Represent Medical Economics in cross-functional forums
• Escalate material roadmap conflicts, dependencies, and decisions requiring leadership alignment
• Report to a Senior Director in the Medical Economics department
• Perform other duties as assigned

Manager, Medical Economics Tooling

Associate

• Serve as a highly engaged analytic partner to drive market performance under the guidance of the Associate Director, Medical Economics
• Analyze regional trends, competitor activities, and industry developments to identify opportunities and risks
• Analyze integrated claims and operational data, including medical, pharmacy, lab, and authorization data, to identify cost and trend drivers
• Provide financial guidance on emerging market trends and potential impacts on financial performance
• Assess market-level programs and integrate them into the central affordability program
• Build retrospective studies measuring financial and clinical outcomes of affordability initiatives against initial projections
• Build repeatable analytical processes that scale across market areas
• Present materials for market finance review meetings and manage follow-up with market leadership
• Develop best practices in analytics, automation, and documentation, contributing to innovation, AI use, and tooling improvements
• Perform other duties as assigned

Associate, Medical Economics

Physician

• Provide high quality care for patients in a virtual setting
• Collaborate with Physicians and/or Advanced Practice Leads on the Care Team when working with complex patients
• Follow up on labs, imaging, and closed loop communication with patients and other providers
• Use tooling for virtual exams, including remote home monitoring equipment, remote physical exam, and remote point-of-care diagnostics
• Participate in a collaborative care model with registered nurses, medical assistants, PCPs, behavioral health clinicians, and clinical supervisors
• Participate in required patient-care meetings, including huddles, case conferencing, and regular service line All Hands
• Provide feedback to improve operational workflows and product features
• Comply with applicable laws and regulations
• Perform other duties as assigned
• Report to the Director, Virtual Health Assessment

Physician, Virtual Health Assessment – Part-Time

Executive Assistant

• Provide high-quality care for patients in a virtual setting
• Use prescriptive authority as part of a collaborative practice agreement, consulting and partnering with Physicians on the care team for comprehensive care, particularly with complex patients
• Follow up on labs, imaging, and closed loop communication with patients and other providers
• Use tooling to allow virtual "exams" including remote home monitoring equipment, remote physical exam, and remote point of care diagnostics
• Participate in a collaborative care model with registered nurses, medical assistants, PCPs, behavioral health clinicians, and clinical supervisors where applicable
• Participate in required meetings including huddles, case conferencing, and regular service line All Hands
• Provide feedback to improve operational workflows and product features
• Comply with all applicable laws and regulations
• Perform other duties as assigned
• Report to the Director, Virtual Health Assessment

Bilingual (Spanish) Physician Assistant – Virtual Health Assessment

• Provide high-quality care for patients in a virtual setting
• Use prescriptive authority as part of a collaborative practice agreement, consulting and partnering with Physicians on the care team for comprehensive care, particularly with complex patients
• Follow up on labs, imaging, and closed loop communication with patients and other providers
• Use tooling to allow virtual exams, including remote home monitoring equipment, remote physical exam, and remote point of care diagnostics
• Participate in a collaborative care model with registered nurses, medical assistants, PCPs, behavioral health clinicians, and clinical supervisors where applicable
• Participate in required meetings including huddles, case conferencing, and regular service line All Hands
• Provide feedback to improve operational workflows and product features
• Comply with all applicable laws and regulations
• Perform other duties as assigned

Nurse Practitioner

• Provide high-quality care for patients in a virtual setting
• Use prescriptive authority as part of a collaborative practice agreement, consulting and partnering with Physicians on the care team for comprehensive care, particularly with complex patients
• Follow up on labs, imaging, and closed loop communication with patients and other providers
• Use tooling to allow virtual “exams” including remote home monitoring equipment, remote physical exam, and remote point of care diagnostics
• Participate in a collaborative care model with registered nurses, medical assistants, PCPs, behavioral health clinicians, and clinical supervisors where applicable
• Participate in required patient-care meetings including huddles, case conferencing, and regular service line All Hands
• Provide feedback to improve operational workflows and product features
• Comply with all applicable laws and regulations
• Perform other duties as assigned
• Report to the Director, Virtual Health Assessment

Senior Director – Member and Provider Services

Senior Analyst, SIU Investigator

Senior Analyst, SIU Investigator

Network Contracting Specialist

Bilingual Physician – Spanish/English

Manager, Risk Adjustment, Provider Partnerships

Senior Clinical Quality Nurse

Senior Manager, Employer Subsidized – New Growth Platforms

Manager, Insurance Product and Benefit Design

Manager, Medical Economics Tooling

Associate, Medical Economics

Physician, Virtual Health Assessment – Part-Time

Bilingual (Spanish) Physician Assistant – Virtual Health Assessment

Bilingual (Spanish) Physician Assistant – Virtual Health Assessment

Nurse Practitioner – Virtual Health Assessment