VP, Member & Provider Services and 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

Hi, we're Oscar. We're hiring a Vice President to oversee our Member & Provider Services and Optimization 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 VP of Member & Provider Services and Optimization is the strategic leader responsible for the performance, scalability, and continuous improvement of the member and provider service experience. You will lead the Member and Provider Services organization, translating high-level goals into actionable operational roadmaps that prioritize member satisfaction, provider engagement, and process optimization. You will be the primary architect of a performance-driven organization. Leading a multi-tiered team of Directors to meet KPIs. You will use Oscar's internal platforms and data-driven insights to build an efficient and compliant operation. By collaborating with multiple peers, you ensure that our service delivery is not only efficient and compliant, but also serves as a differentiator in the healthcare market.

You will report into the SVP of Member & Provider Strategy

Work Location:

This position is based in our New York 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: $218,592 - $286,902.00 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

• 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

Requirements:

• 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

Bonus points:

• Experience in the healthcare or healthtech industry
• Experience with continuous process improvement
• Experience in consulting
• Experience in healthcare payer operations

Travel Requirements

• 5-10% travel which may include representing Oscar operations with strategic provider partners and leadership strategic planning.

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:

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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.

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.