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Salary: USD 180,504 - 236,911 / annual
Oscar Health is seeking a Director, Pharmacy Operations Strategy & Integration to join the Pharmacy team, reporting to the SVP of Pharmacy. This role is central to shaping and executing Oscar's pharmacy operational excellence agenda, translating strategic priorities into coherent portfolios of operating-model improvements, cross-functional programs, vendor capabilities, and scalable workflows that advance affordability, health outcomes, and member and provider experience.
The Director serves as a connective leader across Pharmacy, Clinical, Product, Engineering, Finance, Actuarial, Concierge, Compliance, and PBM/vendor partners—aligning priorities, decisions, and execution to deliver measurable business impact. Key responsibilities include setting pharmacy operational excellence strategy and execution models; leading high-priority pharmacy operational transformation initiatives from strategy through execution; serving as a primary operational partner translating pharmacy and PBM opportunities into clear priorities and measurable outcomes; maintaining deep understanding of the pharmacy and healthcare ecosystem including payer economics, benefit dynamics, claims processes, formulary operations, and prior authorization workflows; partnering with cross-functional teams and external vendors to manage implementation plans and performance monitoring; coordinating across Clinical, Product, Engineering, Finance, and vendor partners to align decision rights and delivery plans; applying an operational excellence lens to diagnose and resolve complex process, data, technology, and vendor friction points; shaping end-to-end member and provider experience by identifying friction points and translating insights into scalable improvements; leading governance and executive reporting for pharmacy initiatives; identifying and managing implementation risks, dependencies, and change-management needs; building repeatable operating playbooks and process standards; using independent judgment to resolve complex problems; supporting capacity planning, budget management, and value realization measurement; and ensuring workflows meet regulatory, compliance, and contractual requirements.
The position is based in the New York City office with a hybrid work schedule requiring 3 days in-office per week. Thursdays are mandatory in-office days for team meetings and events, with the other two office days flexible.
REQUIREMENTS:
- 10+ years of experience in healthcare, business operations, strategy and operations, product operations, or program leadership
- 7+ years of Managed Care, PBM, pharmacy operations, clinical operations, or related healthcare payer experience
- 5+ years leading large-scale, cross-functional strategy, operational transformation, or implementation initiatives from opportunity definition through launch and adoption
- 5+ years partnering directly with cross-functional business, Product, Engineering, vendor, or operations teams to set priorities, define requirements, influence solutions, and deliver business outcomes
- Experience interpreting regulatory, compliance, operational, or contractual business needs and translating them into actionable requirements for cross-functional partners
- Experience with strategic planning, roadmapping, business analysis, operational readiness, change management, and translating priorities into executable cross-functional plans
- Experience translating complex operational data and performance information into executive-level insights, recommendations, and governance materials
- Experience managing budgets, capacity models, business cases, or financial performance for operational or transformation initiatives
BONUS QUALIFICATIONS:
- MBA, MPH, Master's degree in Business Administration or related field
- Management consulting, internal strategy and operations, process engineering, Lean, Six Sigma, or similar structured problem-solving experience
- Experience with PBM implementation, pharmacy benefit administration, claims adjudication, formulary operations, prior authorization, rebate/formulary systems, or healthcare data feeds
- Experience working in matrixed teams through enterprise transformation, implementation, or operational excellence work
