VP, Provider Experience & Operations Leader

Oscar-Health-; New York (NY); Hybride; USD 240 000 - 315 000; Plein temps

Avantages offerts par ce poste

Unlimited vacation program

Company equity grants

Annual performance bonuses

Medical, dental, and vision benefits

Résumé du poste

Oscar Health, based in New York, is seeking a Vice President of Provider Integration and Experience to drive the provider journey, design operational solutions, and lead the enterprise escalation management organization. You will collaborate with Claims, Network, Utilization Management, Payment Integrity, and Technology to translate data-driven insights into systemic improvements and ROI.

This full-time, hybrid role requires executive collaboration and a strong healthcare operations background

Qualifications

• Bachelor’s degree or commensurate 4 years of experience.
• 15+ years of professional experience in healthcare operations, payer operations, network operations, strategic planning, healthcare consulting, or provider relations.
• 7+ years collaborating, influencing, and driving strategic alignment at the executive level (SVP, EVP, and C‑Suite).
• 7+ years of direct senior leadership experience, specifically managing multi-team functions, managers, and directors.
• Deep technical understanding of payer operations, including claims administration, provider data, reimbursement methodologies, utilization management, payment integrity, and provider relations workflows.
• Demonstrated experience building operational models, SLA frameworks, and governance structures in ambiguous environments.
• Master’s degree from a top-tier program in Business Administration (MBA), Health Administration (MHA), Public Health (MPH), or a closely related field.
• Proven success standing up, scaling, or transforming a large-scale provider relations, escalation management, or customer service governance function.
• Extensive experience managing complex partnerships with major national health systems or high‑profile clinical provider networks.
• Proficiency with advanced enterprise workflow tools (e.g., Jira, Salesforce, ServiceNow) and reporting/data environments (e.g., SQL, Tableau).

Responsabilités

• Act as the primary internal and external voice and champion for the provider experience.
• Shape the overarching Oscar Provider Experience strategy, creating a long-term vision to be an easy and dependable partner to providers.
• Develop deep, analytical frameworks and measures to assess the health of the provider experience and evaluate its overall impact on Oscar’s broader network.
• Maintain deep healthcare market and competitor intelligence, keeping a pulse on regulatory changes, vendor innovations, and emerging operational models.
• Build and scale the operating model for escalated provider issues, establishing standardized intake criteria, triage pathways, and closure expectations.
• Oversee the swift resolution of urgent, high-complexity, or high-profile provider escalations that span multiple cross-functional departments.
• Foster strong strategic relationships with SMEs and senior functional leaders across Claims, Network, Utilization Management, Payment Integrity, and Technology to streamline operational handoffs and secure resources for systemic fixes.
• Drive organizational change management, ensuring successful cross-functional adoption of new operational models, workflow metrics, and provider-centric behaviors.
• Leverage robust operational data, analytics, and ROI assessments to identify systemic root causes of provider friction and prioritize technical or operational resolutions.
• Establish tracking mechanisms to guarantee that once a root cause is identified, systemic fixes are fully implemented and verified across strategic accounts.
• Create and deliver executive-ready reporting, interactive dashboards, and strategic recommendations to senior leadership and board members regarding operational health, system trends, and critical blockers.
• Empower and mentor a senior-level team, aligning their personal growth with the delivery of high-impact organizational outcomes.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Description du poste

Oscar Health, based in New York, is seeking a Vice President of Provider Integration and Experience to drive the provider journey, design operational solutions, and lead the enterprise escalation management organization. You will collaborate with Claims, Network, Utilization Management, Payment Integrity, and Technology to translate data-driven insights into systemic improvements and ROI.

This full-time, hybrid role requires executive collaboration and a strong healthcare operations background