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Salary: USD 218,592 - 286,902 / annual
Oscar Health is seeking a Senior Director to lead and scale the Escalated Provider Issue Resolution function within the Network & Provider Management organization. This role owns the strategic design and execution of a multi-disciplinary operating model that handles high-complexity provider escalations, root-cause remediation, and provider service governance.
Key responsibilities include building and leading a multi-team organization focused on strategic provider support, complex issue resolution, and governance. You will establish intake standards, triage criteria, escalation pathways, service metrics, and closure practices for escalated provider issues. The role requires overseeing resolution of high-impact provider issues that span multiple operational teams—including Claims, Network, Utilization Management, Payment Integrity, Contact Center, Account Management, Technology, and Analytics.
You will drive root-cause analysis of escalated issue trends, prioritize operational fixes based on provider impact and enterprise ROI, and establish closed-loop tracking to ensure improvements reduce recurring provider friction. This includes creating executive-ready reporting on provider issue trends, operational health, risks, and decisions needed. You will serve as a senior escalation leader for urgent, complex, or high-profile provider situations and partner across the organization to improve handoffs and reduce avoidable escalations.
The ideal candidate brings 12+ years of healthcare operations experience (provider operations, payer operations, claims, network operations, or provider relations) and 7+ years of senior leadership experience managing managers or multi-team functions. You should have demonstrated success leading complex issue resolution, escalation management, operational transformation, or service model design in healthcare. Strong understanding of payer operations workflows, proven ability to build operating models and governance routines, and experience leading change management across cross-functional teams are essential. Analytical rigor, executive communication, and stakeholder management skills are critical. Bonus experience includes standing up or transforming provider service functions, supporting strategic provider relationships, and proficiency with workflow tools (Jira, Salesforce, ServiceNow, Zendesk) or data analysis (Excel, SQL).
