SlipstreamJobs tracks this role from the company's public career site. Apply directly on the employer's site.
Salary: USD 261,565 - 381,449 / annual
Oscar Health is seeking a Market Medical Officer for the Atlantic region to serve as the clinical executive leading market performance, care access expansion, and affordability initiatives. Reporting to the Vice President of Clinical Affairs, you will optimize medical cost trends and reimbursement strategies while balancing financial sustainability with plan performance. You will act as the primary clinical liaison, executing regional programs and bridging corporate operations with local provider leadership.
Key responsibilities include driving performance of clinical metrics (ED/K, APK, ALOS) in partnership with market P&L leadership; identifying utilization trends and developing solutions to reduce overall spend; building strategic partnerships with health systems and physician groups to align incentives and lower total cost of care; serving as regional clinical partner across internal teams (Affordability, UM, Care Management, Claims); guiding clinical initiatives with Network Contracting to enhance provider alignment and outcomes; identifying and resolving regional network gaps and access barriers; collaborating with regulatory agencies on network adequacy and quality compliance; and serving as point of accountability for regional escalations including appeals, grievances, and complex case management.
This is a remote position open to candidates residing in Arizona, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, or Virginia. Occasional travel may be required for team meetings and company events.
REQUIREMENTS:
- 12+ years of progressive leadership experience in healthcare
- 10+ years of experience in managed care with prior experience leading in a matrix environment
- 7+ years of clinical leadership experience in market-specific role
- 7+ years of experience managing clinical market trends in health insurance or full risk-bearing clinical provider groups
- 5+ years of clinical practice and board certification in internal medicine, family medicine, general surgery, emergency medicine (other fields considered)
- 5+ years of experience leading teams
- MD or DO with current unrestricted license to practice medicine in one of the following states: GA, NC, SC, NJ, NY, PA, or VA
- Must maintain active board certification
- Willing and able to obtain additional state licensure with Oscar's support
Bonus qualifications: P&L experience for risk-bearing entity, licensure in multiple Oscar states, Master's degree or advanced certificate, prior utilization management experience.
