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Salary: USD 196,732 - 258,211 / annual
Oscar Health, a technology-driven health insurance company founded in 2012, is seeking a Senior Director to lead and scale their Escalated Provider Issue Resolution function within the Network & Provider Management organization. This is a newly built or transforming function focused on supporting strategic provider accounts, managing high-complexity escalations, driving root-cause remediation, and establishing provider service governance.
You will lead a multi-disciplinary team and partner across Claims, Network, Utilization Management, Payment Integrity, Contact Center, Account Management, Technology, and Analytics to improve how Oscar identifies, routes, resolves, and prevents provider issues. Key responsibilities include building a scalable operating model with intake standards, triage criteria, escalation pathways, and closure practices; overseeing resolution of high-impact provider issues requiring cross-functional coordination; analyzing escalated issue trends to identify and prioritize root causes based on provider impact and enterprise ROI; establishing closed-loop tracking to ensure fixes are adopted and reduce recurring friction; creating executive-ready reporting on provider issue trends and operational health; and serving as a senior escalation leader for urgent, complex, or high-profile provider situations.
You will report to the SVP of Network and Provider Management. The role requires 12+ years of healthcare operations experience (provider operations, payer operations, claims, network operations, or related fields) and 7+ years of senior leadership experience leading managers or multi-team functions. You should have demonstrated expertise in complex issue resolution, escalation management, operational transformation, and service model design in healthcare; deep understanding of payer operations workflows; proven ability to build operating models, governance routines, and accountability mechanisms; and strong change management and stakeholder communication skills. Bonus experience includes standing up or transforming provider service or escalation functions, supporting strategic provider relationships and large health systems, familiarity with workflow tools (Jira, Salesforce, ServiceNow, Zendesk), and data analysis capabilities (Excel, SQL, dashboards, SLA reporting).
