Senior Director, Escalated Provider Issues (Remote)

Namely; Atlanta (GA); On-site; USD 196,732 - 258,211; Full time

Job summary

Oscar Health is seeking a Senior Director, Escalated Provider Issue Resolution to join our Network & Provider Management team. The role leads a multidisciplinary organization focused on strategic provider accounts, high-complexity escalations, and governance to improve issue identification, routing, and resolution.

You will report to the SVP and build a scalable operating model, partner across Claims, Network, Utilization Management, and Analytics, and drive cross-functional improvements while

Qualifications

• 12+ years of experience in healthcare operations or related fields.
• 7+ years of senior leadership experience managing managers or multi-team functions.
• Experience leading complex issue resolution and escalation management in healthcare.
• Strong understanding of payer operations including claims and network workflows.
• Proven ability to build operating models, governance routines, and metrics.
• Experience driving change across cross-functional teams.
• Strong analytical and executive communication skills.
• Ability to operate in ambiguity and build new functions.

Responsibilities

• Lead a multi-disciplinary provider issue resolution organization.
• Build a scalable operating model for escalated issues.
• Oversee high-impact provider issues requiring cross-team coordination.
• Partner with Claims, Network, Utilization Management, Payment Integrity, and others to improve handoffs.
• Establish closed-loop tracking to address root causes.
• Create executive-ready reporting on provider trends and risks.
• Serve as senior escalation leader for urgent issues.
• Ensure compliance with laws and regulations.
• Perform other duties as assigned.

Skills

Escalation management

Leadership

Analytics

Stakeholder management

Cross-functional collaboration

Executive communication

Change management

Problem solving

Tools

Jira

Salesforce

ServiceNow

Zendesk

Job description

Oscar Health is seeking a Senior Director, Escalated Provider Issue Resolution to join our Network & Provider Management team. The role leads a multidisciplinary organization focused on strategic provider accounts, high-complexity escalations, and governance to improve issue identification, routing, and resolution.

You will report to the SVP and build a scalable operating model, partner across Claims, Network, Utilization Management, and Analytics, and drive cross-functional improvements while