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Salary: USD 196,732 - 258,211 / annual
Oscar Health 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 transformed operating model 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 clear intake standards, triage criteria, escalation pathways, and service metrics; 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 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.
The ideal candidate brings 12+ years of healthcare operations experience (provider operations, payer operations, claims, network, or provider relations) and 7+ years of senior leadership managing managers or multi-team functions. You should have demonstrated success leading complex issue resolution, escalation management, or operational transformation in healthcare; deep understanding of payer operations workflows; proven ability to build operating models, governance routines, and accountability mechanisms; and experience leading change management across cross-functional teams. Strong analytical skills, executive communication, stakeholder management, and comfort operating in ambiguity are essential. Bonus experience includes standing up or transforming provider service or escalation functions, supporting strategic provider relationships or large health systems, familiarity with workflow tools (Jira, Salesforce, ServiceNow, Zendesk), building operational dashboards and SLA reporting, or advanced Excel/SQL/data analysis skills.
