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Salary: USD 64,832 - 89,144 / annual
Oscar Health is seeking an Associate Manager for Member & Provider Escalations to lead and develop a team focused on operational excellence within their CG&A/MPCT department. This role manages complex member and provider escalations, resolves process roadblocks, and partners cross-functionally to address root business challenges.
Key responsibilities include mentoring team members using structured frameworks to build future leaders and foster positive workplace culture. You will manage daily team operations, performance measurement, employee engagement, and cross-functional communications with indirect budget oversight. The role involves managing grievance and appeals workflows as the primary department escalation point for complex cases, using data to identify root causes and reduce complaint volume.
You will manage high-visibility cases from intake through resolution, collaborating with executive leadership to mitigate operational and reputational risk. The position requires identifying operational trends and knowledge gaps across Service Operations, applying Lean methodologies to lead proactive process improvements. You will establish and enforce standard escalation procedures to maintain compliance and eliminate customer friction, while partnering with leaders across the organization to translate business insights into strategies that improve operational efficiency and customer experience.
The role requires 3+ years leading and developing teams in production or contact center environments, 2+ years working with multi-location and multi-disciplinary teams, 2+ years in collaborative diverse environments, 2+ years implementing operational excellence, 2+ years using data for decision-making and continuous improvement, and 2+ years with advanced Google Suite or Microsoft Office capabilities. Healthcare or insurance experience, complaints/grievances/appeals background, bachelor's degree, data visualization tool proficiency, and operational excellence certifications are valued.
