Director, Pharmacy Operations Strategy & Integration

Oscar Health; New York (NY); Hybrid; USD 181,000 - 237,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

Equity grants

Unlimited vacation

Hybrid work schedule

Job summary

Oscar Health, based in New York, seeks a Director to shape and execute the pharmacy operations strategy, driving affordability, outcomes, and member/provider experiences. The role collaborates across Pharmacy, Clinical, Product, Engineering, Finance, and PBM/vendor partners to deliver measurable impact within a hybrid New York City office.

The position reports to the SVP, Pharmacy and requires 10+ years in healthcare/ops, with 7+ years in managed care or pharmacy operations, and an MBA/MPH

Qualifications

• 10+ years of experience in healthcare, business operations, strategy and operations, product operations, or program leadership.
• 7+ years of Managed Care, PBM, pharmacy operations, clinical operations, or related healthcare payer experience.
• 5+ years leading large-scale cross-functional strategy, operational transformation, or implementation initiatives from opportunity definition through launch and adoption.
• 5+ years partnering with cross-functional teams to set priorities, define requirements, influence solutions, and deliver outcomes.
• Experience interpreting regulatory, compliance, or contractual needs into actionable requirements for partners.
• Experience with strategic planning, roadmapping, business analysis, operational readiness, and change management.
• Experience translating data into executive insights and governance materials.
• Experience managing budgets, capacity models, or financial performance for transformation initiatives.

Responsibilities

• Set the pharmacy operational excellence strategy, operating rhythm, and execution model.
• Lead high-priority pharmacy transformation initiatives from strategy through execution.
• Partner with internal and external teams to translate opportunities into priorities and measurable outcomes.
• Ensure awareness of regulatory requirements and translate needs into actionable solutions.
• Maintain understanding of payer economics, formulary operations, and prior authorization workflows.
• Coordinate with stakeholders and vendors on implementation plans, reviews, and delivery plans.
• Shape end-to-end member and provider experiences by identifying friction points and enabling improvements.
• Lead governance and executive reporting for pharmacy initiatives with data-driven recommendations.

Skills

Healthcare operations

Strategic planning

Cross-functional leadership

Regulatory knowledge

Vendor management

PBM/pharmacy operations

Budget & financials

Education

MBA

MPH

Master's degree in Business Administration or related field

Job description

Director, Pharmacy Operations Strategy & Integration

New York, New York, United States

Hi, we're Oscar. We're hiring a Director, Pharmacy Operations Strategy & Integration to join our Pharmacy team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless 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 Director, Pharmacy Operations Strategy & Integration reports to the SVP, Pharmacy is responsible for shaping and executing Oscar's pharmacy operational excellence agenda for the Pharmacy Clinical Strategy and Operations area. This role translates strategic priorities into a coherent portfolio of operating-model improvements, cross-functional programs, vendor capabilities, and scalable workflows that advance affordability, health outcomes, and the member and provider experience. The Director serves as a connective leader across Pharmacy, Clinical, Product, Engineering, Finance, Actuarial, Concierge, Compliance, and PBM/vendor partners—aligning priorities, decisions, and execution to deliver measurable business impact. This role balances enterprise affordability, member and provider experience, regulatory compliance, operational quality, and long-term scalability as Oscar advances its pharmacy operating model.

You will report into the SVP, Pharmacy.

Work Location: This position is based in our New York City office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid

Pay Transparency: The base pay for this role is: $180,504.00 - $236,911.00 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

• Set the pharmacy operational excellence strategy, operating rhythm, and execution model, ensuring priorities are aligned to Oscar's enterprise agenda, Pharmacy objectives, affordability goals, and member and provider outcomes.
• Lead high-priority pharmacy operational transformation initiatives from strategy through execution, including opportunity definition, roadmap development, operational readiness, launch planning, and sustained adoption.
• Serve as a primary operational partner across internal and external teams, translating pharmacy and PBM opportunities, member and provider needs, and frontline insights into clear priorities, decisions, and measurable outcomes.
• Stay aware of applicable PBM, pharmacy benefit, managed care, and healthcare regulatory requirements, interpreting the business need and communicating it clearly to internal and external partners so solutions are designed and implemented appropriately.
• Maintain deep understanding of the pharmacy and healthcare ecosystem, including payer economics, benefit and network dynamics, claims processes, formulary operations, prior authorization workflows, utilization patterns, vendor handoffs, and the drivers of affordability and experience.
• Partner with cross-functional internal stakeholders and external vendors to manage implementation plans, business reviews, strategic meetings, issue escalation, performance monitoring, and operational integration.
• Coordinate cross-functionally across Clinical, Pharmacy Operations, Product, Engineering, Finance, Actuarial, Concierge, and vendor partners to align decision rights, dependencies, tradeoffs, and delivery plans for high-priority pharmacy initiatives.
• Serve as an internal consultant and apply an operational excellence lens to diagnose complex process, data, technology, and vendor friction points, then design practical end-to-end solutions that improve throughput, quality, affordability, and member/provider experience.
• Shape the end-to-end member and provider experience by partnering with Pharmacy, Clinical, Product, Engineering, Concierge, and vendor teams to identify friction points and translate insights into scalable, measurable improvements across pharmacy journeys.
• Lead governance and executive reporting for pharmacy operational excellence initiatives, synthesizing operational, member, provider, clinical, and financial data into clear priorities, recommendations, and accountability for senior leadership.
• Identify and manage implementation risks, dependencies, decisions, and change-management needs, ensuring stakeholders understand scope, impact, tradeoffs, and operational readiness requirements.
• Build repeatable operating playbooks, process standards, controls, and best practices that support a scalable PBM operating model, continuous improvement, and a coherent end-to-end pharmacy experience.
• Use independent judgment to resolve complex problems, evaluate variable factors, and determine the best course of action for technology-enabled process improvement and operational transformation.
• Support capacity planning, budget management, business-case development, and value realization measurement for PBM, vendor, and operational excellence initiatives.
• Ensure operational workflows, vendor capabilities, and program execution meet applicable regulatory, compliance, quality, and contractual requirements.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• 10+ years of experience in healthcare, business operations, strategy and operations, product operations, or program leadership.
• 7+ years of Managed Care, PBM, pharmacy operations, clinical operations, or related healthcare payer experience.
• 5+ years leading large-scale, cross-functional strategy, operational transformation, or implementation initiatives from opportunity definition through launch and adoption.
• 5+ years partnering directly with cross-functional business, Product, Engineering, vendor, or operations teams to set priorities, define requirements, influence solutions, and deliver business outcomes.
• Experience interpreting regulatory, compliance, operational, or contractual business needs and translating them into actionable requirements for cross-functional partners.
• Experience with strategic planning, roadmapping, business analysis, operational readiness, change management, and translating priorities into executable cross-functional plans.
• Experience translating complex operational data and performance information into executive-level insights, recommendations, and governance materials.
• Experience managing budgets, capacity models, business cases, or financial performance for operational or transformation initiatives.
• MBA, MPH, Master's degree in Business Administration or a related field preferred.
• Management consulting, internal strategy and operations, process engineering, Lean, Six Sigma, or similar structured problem-solving experience.
• Experience with PBM implementation, pharmacy benefit administration, claims adjudication, formulary operations, prior authorization, rebate/formulary systems, or healthcare data feeds.
• Experience working in a matrixed teams through enterprise transformation, implementation, or operational excellence work.

This is an authentic Oscar Health job opportunity.

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.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

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 ([e-mail]) 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 Privacy Policy .

Oscar Health is authorized to do business in many, but not all, states. If you are not located in or willing to relocate to a state where Oscar is registered, you will not be eligible for employment. The approved states for this role are listed in the job posting.

Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file.

As set forth in Oscar Health’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.