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Salary: USD 261,565 - 381,449 / annual
Oscar Health is seeking a Market Medical Officer for the Texas + West region to serve as the clinical executive leading the Clinical Affairs team. This role is responsible for driving market performance, expanding care access, and enhancing affordability across the region while optimizing medical cost trends and reimbursement strategies.
You will report directly to the VP of Clinical Affairs and serve as the primary clinical liaison between corporate operations and local provider leadership. Key responsibilities include:
- Drive performance of key clinical metrics (ED/K, APK, ALOS, etc.) for trend management and market performance in partnership with market P&L leadership
- Partner with Medical Economics to identify market-based utilization trends and develop solutions to reduce overall spend
- Build strategic partnerships with health systems, physician groups, and community providers to align incentives and lower total cost of care
- Serve as regional clinical partner across internal teams including Affordability, Utilization Management, Care Management, and Claims
- Partner with Network Contracting leadership to guide clinical initiatives that enhance provider alignment, care quality, and clinical outcomes
- Identify and resolve regional network gaps and access barriers to advance equitable, high-quality care
- Collaborate with regulatory agencies and compliance teams to ensure regional network adequacy and quality programs comply with state and federal requirements
- Serve as point of accountability for regional escalations including appeals, provider and member grievances, and complex case management scenarios
This is a fully remote position open to candidates residing in the U.S., excluding Alaska, Delaware, Hawaii, Louisiana, Montana, North Dakota, Oklahoma, West Virginia, Wyoming, and U.S. Territories. Occasional travel is required for team meetings and company events.
**Requirements:**
- MD or DO with current unrestricted license to practice medicine in one of the region states (TX, AZ, MO, OK)
- 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 the market region
- 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 certified in internal medicine, family medicine, general surgery, emergency medicine (other fields considered)
- 5+ years of experience leading teams
- Must maintain active board certification and willing 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 experience with Utilization Management
