Remote Senior Director, Escalated Provider Issue Resolution

Oscar Health; Atlanta (GA); À distance; USD 197 000 - 258 000; Plein temps

Avantages offerts par ce poste

Unlimited vacation

Company equity grants

Annual performance bonuses

Remote-first

Résumé du poste

Oscar Health seeks a Senior Director, Escalated Provider Issue Resolution to lead a multi-disciplinary team within Network & Provider Management. You will drive strategic provider support, complex issue resolution, and governance, building scalable operating models and cross-functional collaboration across Claims, Network, and Analytics.

The role reports to the SVP of Network and Provider Management and is remote (Atlanta-area candidates welcome with potential hybrid options).

Qualifications

• 12+ years of experience in healthcare/ payer operations or related field.
• 7+ years of senior leadership experience leading managers or multi-team functions.
• Experience leading complex issue resolution, escalation management, or service model design in healthcare.
• Ability to build operating models, governance routines, and performance metrics across teams.
• Experience leading change management and adoption of new operating models.

Responsabilités

• Lead a multi-disciplinary provider issue resolution organization with strategic support, complex issue resolution, and governance.
• Build a scalable operating model for escalated provider issues with intake standards, triage criteria, and escalation pathways.
• Oversee resolution of high-impact issues requiring cross-team coordination.
• Partner with Claims, Network, Utilization Management, Payment Integrity, and Analytics to improve handoffs and reduce escalations.
• Drive root-cause remediation by analyzing trends and prioritizing fixes based on ROI.
• Establish closed-loop tracking to ensure root causes are addressed and improvements reduce friction.
• Create executive-ready reporting on provider issue trends and operational health.
• Serve as a senior escalation leader for urgent, complex provider issues.

Connaissances

Analytical

Executive comms

Stakeholder mgmt

Change mgmt

Ambiguity tolerance

Leadership

Cross-functional collaboration

Formation

Bachelor's degree or higher in a related field

Outils

Jira

Salesforce

ServiceNow

Zendesk

Description du poste

Oscar Health seeks a Senior Director, Escalated Provider Issue Resolution to lead a multi-disciplinary team within Network & Provider Management. You will drive strategic provider support, complex issue resolution, and governance, building scalable operating models and cross-functional collaboration across Claims, Network, and Analytics.

The role reports to the SVP of Network and Provider Management and is remote (Atlanta-area candidates welcome with potential hybrid options).