VP, Member & Provider Experience & Optimization

Oscar Health; New York (NY); Hybrid; USD 218,592 - 286,902; Full time

Job summary

Oscar Health in New York is seeking a Vice President to lead the Member & Provider Services and Optimization Team. You will translate high-level goals into operational roadmaps, driving member satisfaction, provider engagement, and scalable, compliant service delivery.

You will manage a multi-tier organization with Directors, set performance benchmarks, and employ AI/automation to build the call center of the future.

Qualifications

• 15+ years of professional experience.
• 5+ years experience in managing a large organization with onshore and offshore colleagues.
• 5+ years experience leading large call center operations.
• 5+ years experience operational planning, workforce management and budgeting.
• Experience operating in a regulated environment.

Responsibilities

• Direct the Member & Provider Services organization, overseeing a scalable operating model designed to optimize the end-to-end experience for our entire service ecosystem, including members, providers, and broker call center operations.
• Summarize departmental strategies into operational roadmaps, leading the implementation of programs that reduce friction in member navigation and provider service workflows.
• Cultivate a culture by guiding the evolution of specialized service tools and data-led workflows that empower teams to resolve complex member and provider needs.
• Define and refine the performance management philosophy, using member and provider feedback loops to set rigorous benchmarks for service excellence and optimization.
• Define, socialize and implement the call center of the future, using AI, automation, self service and analytics to accelerate Oscar's industry-leading experiences
• Improve workforce mix to maximize flexibility, efficiency, business continuity and overall experience.
• Be a primary voice of customer and advise and direct internal projects to ensure they are aligned with our experience goals.
• Lead a multi-leveled organization, including multiple levels of managers, to exceed targets in quality and productivity, optimizing every interaction to balance member empathy with regulatory and fiscal requirements.
• Ensure teams are equipped and future-ready through advanced service tools and professional development, and build a talent bench that fosters growth for both individual contributors and new leaders.
• Lead a culture of continuous optimization, using data-driven root cause analysis to identify systemic pain points in the member and provider experience and deploying sustainable, scalable solutions.
• Oversee budgeting and capacity planning, providing data-backed business cases for investments that scale our ability to support a growing member and provider base.
• Oversee the integration of quality improvement projects, ensuring that you improve member-facing and provider-facing programs to provide reliable, seamless access to care.
• Be a senior Oscar ambassador to external partners and regulators, representing the department's optimized approach to member advocacy and provider relations.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Job description

Oscar Health in New York is seeking a Vice President to lead the Member & Provider Services and Optimization Team. You will translate high-level goals into operational roadmaps, driving member satisfaction, provider engagement, and scalable, compliant service delivery.

You will manage a multi-tier organization with Directors, set performance benchmarks, and employ AI/automation to build the call center of the future.