Market Medical Officer, Texas + West

Oscar Health, Inc.; Texas; Remote; USD 262,000 - 343,000; Full time

Job summary

Oscar Health, Inc. is seeking a Market Medical Officer for Texas + West to lead clinical strategy in the remote role, reporting to VP Clinical Affairs. You will partner with P&L leadership to drive market performance and expand care access.

The position focuses on balancing cost trends with plan performance, building provider partnerships, and ensuring regulatory compliance across the region. Travel is occasional; remote home office in TX/AZ/MO.

Qualifications

• 12+ years of progressive leadership in healthcare.
• 10+ years in managed care with prior matrix leadership.
• 7+ years of clinical leadership in market.
• MD/DO with current unrestricted license in TX/AZ/MO/OK.

Responsibilities

• Drive clinical performance and market performance with market leadership.
• Identify utilization trends with Med Econ and develop cost-reduction solutions.
• Build partnerships with health systems and providers to lower total cost of care.
• Ensure regional network adequacy and regulatory compliance.
• Act as regional clinical liaison across internal teams.

Skills

Leadership

Healthcare industry knowledge

Market analytics

Cross-functional collaboration

Strategic planning

Education

MD/DO with unrestricted license

Job description

Hi, we're Oscar. We're hiring a Market Medical Officer, Texas + West to join our Clinical Affairs 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 Market Medical Officer is the clinical executive for Texas + West region, partnering with P&L leadership to drive market performance, expand care access, and enhance affordability. This role optimizes medical cost trends and reimbursement strategies to balance financial sustainability with plan performance. As the primary clinical liaison, the Market Medical Officer executes regional initiatives while seamlessly bridging corporate operations with local provider leadership.

You will report into the VP Clinical Affairs.

Work Location

This position is fully remote and open to candidates residing in Texas, Arizona or Missouri. Daily work is completed from your home office, with occasional travel required for team meetings and company events.

Pay Transparency

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $290,628- $381,449 per year. The base pay for this role in all other locations is: $261,565 - $343,304 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities

• Drive performance of key clinical metrics for trend management and market performance of plans in their region including but not limited to ED/K, APK, ALOS and others in partnership with market P&L leadership.
• Work in partnership with Med Econ to identify market based utilization trends and flares and develop solutions to address key drivers to reduce overall spend.
• Build strategic partnerships with health systems, physician groups, and community providers to align incentives and lower the total cost of care.
• Serve as regional clinical partner across internal teams, partnering closely with Affordability, Utilization Management (UM), Care Management (CM), Claims, and others to drive regional performance goals.
• Partner with Network Contracting leadership to guide clinical initiatives that enhance provider alignment, care quality, and clinical outcomes across the region.
• Proactively identify and resolve regional network gaps and access barriers to advance equitable, high-quality care across all member populations.
• Collaborate with regulatory agencies and compliance teams to ensure regional network adequacy and quality programs comply with state and federal requirements, translating policy changes into proactive operational strategy that protect member access and organizational performance.
• Serve as the point of accountability for regional escalations, including internal/external appeals, provider and member grievances, and complex case management scenarios.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Requirements

• 12+ years of progressive leadership experience in healthcare.
• 10+ years of experience in managed care with prior experience leading in a matrix environment.
• 7+ years of experience of clinical leadership in role specific market.
• 7+ years of experience managing clinical market trend in health insurance or full risk bearing clinical provider groups.
• 5+ years of clinical practice and board certified in one of the following fields: internal medicine, family medicine, general surgery, emergency medicine (other fields will be considered).
• 5+ years of experience leading teams.

Education

• MD or DO with a current unrestricted license to practice medicine is required in a state in the region (TX, AZ, MO, OK).

License And Certification

• Reviewers must maintain necessary credentials to retain the position including maintaining active board certification.
• Willing and able to obtain additional state licensure (with Oscar’s support).

Bonus Points

• P&L experience for risk bearing entity.
• Licensure in multiple Oscar states.
• Masters degree or advanced certificate.
• Prior experience with Utilization management.

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.

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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.

This is an authentic Oscar Health job opportunity.