Teams at Oscar Health

Supports healthcare provider network growth by executing network construction plans, conducting provider outreach, assisting with contract negotiations, sourcing providers, meeting contracting metrics and SLAs, documenting feedback, and ensuring regulatory compliance. The role is remote within Arizona, Florida, Georgia, or Texas and requires up to 20% travel.

Leads administrative complaints, grievances, appeals, and escalation operations across healthcare insurance lines of business. Oversees compliance, quality, audit readiness, regulatory turnaround times, workforce capacity, vendor performance, and high-risk issue resolution. Manages multi-tiered teams, partners with Claims, Network, Legal, and Compliance, uses case data and Lean methods to address root causes, and presents operational and compliance insights to executive leadership.

Leads Oscar’s provider-facing risk adjustment program, managing strategy, implementation, cross-functional delivery, provider relationships, performance analysis, documentation and coding improvement initiatives. Partners with network, legal, market, data science, and risk adjustment teams to integrate requirements into provider agreements and operating models. Develops reporting, education, engagement, incentives, and mitigation plans while managing risks, dependencies, and stakeholder communications. The role is fully remote in eligible U.S. locations with occasional travel.