About the role
Hi, we're Oscar. We're hiring a Senior Director, Escalated Provider Issue Resolution to join our Network & Provider Management 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 Senior Director, Escalated Provider Issue Resolution team supports strategic provider accounts, high-complexity escalations, root-cause remediation, and provider service governance. This role will build and scale the operating model for escalated provider issue resolution, lead a multi-disciplinary team, and partner across Claims, Network, Utilization Management, Payment Integrity, Contact Center, Account Management, Technology, Analytics, and senior leadership to improve how Oscar identifies, routes, resolves, and prevents provider issues. This position will report to the SVP, Network and Provider Management. You will report into the SVP, Network & Provider Management Work Location: This position is based in our Tempe, Arizona 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: $196,732 - $258,211 per year. You are also eligible for employee
benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.
Responsibilities: Lead and develop a multi-disciplinary provider issue resolution organization, including teams focused on strategic provider support, complex issue resolution, root-cause remediation, and provider service governance. Build a scalable operating model for escalated provider issues, including intake standards, triage criteria, escalation pathways, ownership expectations, service metrics, and closure practices. Oversee resolution of high-impact provider issues that require coordination across multiple operational teams. Partner with leaders across Claims, Network, Utilization Management, Payment Integrity, Contact Center, Account Management, Technology, and Analytics to improve handoffs, reduce avoidable escalations, and address recurring root causes. Oversee root-cause remediation by analyzing escalated issue trends, prioritizing fixes based on provider impact and enterprise ROI, and driving cross-functional follow-through on the highest-value operational improvements. Establish closed-loop tracking to ensure identified root causes are addressed, operational fixes are adopted, and improvements reduce recurring provider friction across strategic accounts and the broader provider network. Create executive-ready reporting on provider issue trends, operational health, risks, blockers, and decisions needed. Serve as a senior escalation leader for urgent, complex, or high-profile provider issues. Compliance with all applicable laws and regulations Other duties as assigned
