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Senior Director, Network Adequacy

Oscar Health

Oscar Health

Sales & Business Development
Remote
Posted on Thursday, July 4, 2024

Hi, we're Oscar. We're hiring a Senior Director, Network to join our P&L 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

Responsible for operationalizing network adequacy standards and for working across the market P&Ls, legal, regulatory, configuration, credentialing and provider data teams to ensure ongoing compliance with network adequacy requirements.

You will report to the Senior Vice President, P&L.

Work Location:

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.

If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.

You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

Pay Transparency:

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $211,200 - $290,400 per year. The base pay for this role in all other locations is: $190,080 - $249,480 per year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities

  • Ensure the organization maintains an always-current understanding of Oscar’s market-level network strength as measured by state and federal adequacy standards including partnering with internal and external parties for the reporting, data and insights needed to operationalize improvement opportunities with accountable teams
  • Work with respective Market Leadership to ensure they understand the efficiency and effectiveness of their Direct Contracting efforts and opportunities and requirements for improvement against standards
  • Build and lead a matrixed Direct Contracting tiger team to allow for market-level augmentation on dedicated efforts to build or repair provider networks
  • Develop and run an enterprise-level governance framework for Network Adequacy including leveraging internal and external standards, measurements for success, enterprise reporting on network status, progress toward goals, and risks
  • Partner cross-functionally to identify process improvements and implement solutions related to network implementation and maintenance
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Qualifications

  • A bachelor's degree or commensurate 4 years of experience
  • 12+ years of experience in healthcare industry
  • 7+ years of healthcare experience focused on network development and provider management

Bonus Points

  • Experience working with legal and regulatory teams to provide strategic recommendations and ensure compliance with network adequacy requirements
  • Proven experience leading and managing large scale initiative and cross organizational projects

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

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.

California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Notice to Job Applicants.