Director, Case Management Operations

Summary

Join Oscar as our Director of Case Management Operations and lead our Clinical Care team in driving the Case Management team's business strategy, program design, and outcomes. You will be responsible for the department's success and financial performance, focusing on both administrative efficiency and affordability. This role involves directing and influencing teams in developing new programs and optimizing existing ones to reduce medical costs and improve member health outcomes. You will report to the Senior Director, Virtual Care and work in a blended work culture, with a requirement to come into the office at least twice a week if within commuting distance of our NYC, Tempe, or LA offices; otherwise, it's a remote position. The role offers a competitive salary, benefits, unlimited vacation, equity grants, and annual performance bonuses. This position requires significant experience in healthcare strategy, operations, and Case Management.

Requirements

• 10+ years experience in healthcare strategy and operations, and/or related field
• 6+ years of management experience
• 5+ years of program design experience, with specific experience around Case Management program design
• 3+ years of Case Management experience driving medical cost savings and health outcomes
• 3+ years experience in leading large-scale cross functional initiatives
• Clinical licensure (clinical social worker, pharmacist, RN)
• Experience modeling in Excel / Google Sheets

Responsibilities

• Set, drive and execute on the Case Management department strategy and vision to deliver meaningful affordability outcomes for Oscar's population
• Develop direct reports, ensuring the team's responsibilities are clear, and owners are accountable to outcomes
• Develop and maintain playbooks on how we approach novel ideas via programs and build scalable and repeatable processes to manage down trend
• Understand the competitive landscape of the department and act as a thought leader for the particular SME the department runs
• Work cross functionally with other departments to bring new ideas to life and hold accountable through indirect management (e.g. reducing friction with Member Experience, Med Econ sizing of opportunities)
• Program management of key company and department strategy initiatives
• Own and continuously evaluate financial and outcome performance of the department
• Drive the budgeting process and the fiscal performance for the team
• Report to Senior Leadership on the health of the business
• Compliance with all applicable laws and regulations
• Other duties as assigned

Preferred Qualifications

• Master's degree
• Management Consulting experience with a focus on healthcare
• Experience in a growth-stage company
• Population Health background
• Experience delivering programs specifically for an ACA population

Benefits

• Medical, dental, and vision benefits
• 11 paid holidays
• Paid sick time
• Paid parental leave
• 401(k) plan participation
• Life and disability insurance
• Paid wellness time and reimbursements