Medical Director – Scientific Affairs

Oscar Health

. Serve as the primary evidence-based subject matter expert, translating clinical research into actionable strategies to elevate care quality across the organization .

Posted 9/18/2026full-timeRemote • Florida • United StatesLead💰 $237,719 - $312,006 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in clinical policy development, evidence-based research, and leadership in multi-disciplinary clinical committees. Proficient in translating clinical research into actionable strategies while ensuring compliance with regulatory standards.

Highest-signal resume keywords

Clinical Policy DevelopmentEvidence-Based ResearchLeadership in Clinical CommitteesMedical Degree (MD or DO)Active Board Certification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Policy DraftingMedical Coding TerminologiesData-Driven InsightsSystematic ReviewsUtilization Management (UM)Pharmacy Coverage PoliciesGrading Clinical EvidenceClinical Advisory SubcommitteesEmerging Medical TherapiesPopulation Health Utilization Patterns

Soft Skills

Communication with ExecutivesInterpersonal SkillsFacilitation SkillsCollaboration

Certifications & Qualifications

Active Board Certification (ABMS or AOA)

Industry Keywords

Health InsurancePharmacy Benefit Manager (PBM)Clinical GuidelinesNCQA StandardsFDACMSState DOIASCOACCAACE

About the role

Key responsibilities & impact

Serve as the primary evidence-based subject matter expert, translating clinical research into actionable strategies to elevate care quality across the organization
Lead the research, development, revision, and clinical accuracy of all medical, utilization management (UM), and pharmacy coverage policies
Advise executive leadership on emerging medical therapies, complex clinical trends, and population health utilization patterns using data-driven insights
Support the development of clinical and lifestyle products through evidence-based research tailored to target populations
Foster academic partnerships to advance and publish clinical research leveraging health plan population data
Lead systematic reviews of major specialty society guidelines, including ASCO, ACC, and AACE
Establish, maintain, and enforce the framework for grading clinical evidence
Oversee Clinical Advisory Subcommittees by setting agendas, presenting clinical evidence packages, and driving expert consensus
Partner with Pharmacy Services, Legal, and Compliance to integrate coverage policies meeting NCQA standards and state/federal mandates
Support interactions with federal and state regulatory bodies, including FDA, CMS, and State DOIs
Comply with all applicable laws and regulations
Perform other responsibilities as assigned

Requirements

What you’ll need

10+ years working in relevant fields
6+ years clinical policy experience in health insurance, PBM, or other clinical guideline development organization
4+ years experience in clinical policy drafting and development
4+ years of experience leading, chairing, or facilitating multi-disciplinary clinical committees or advisory subcommittees
4+ years publishing in relevant fields
3+ years of experience communicating with executives and interacting with all levels of the organization
3+ years of leadership experience as a people manager
1+ years of experience with medical coding terminologies (HCPCs, CPT, ICD-10)
Medical Degree (MD or DO): Required from an accredited school of medicine or osteopathic medicine
Active board certification recognized by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA)

Benefits

Comp & perks

Employee benefits
Unlimited vacation program
Company equity grants
Annual performance bonuses
Medical benefits
Dental benefits
Vision benefits
11 paid holidays
Paid sick time
Paid parental leave
401(k) plan participation
Life insurance
Disability insurance
Paid wellness time and reimbursements