Note: The job is a remote job and is open to candidates in USA. Oscar Health is a health insurance company built around a technology platform focused on serving its members. They are looking for a Director of Provider Operations to lead and optimize provider data management, contracting, and credentialing processes while collaborating with cross-functional teams to enhance operational capabilities.
Responsibilities
- Provide strategic leadership and operational oversight for the end-to-end provider data lifecycle, ensuring the precise and timely execution of provider credentialing, contract loading, and daily data management
- Lead, coach, and develop a high-performing, multi-tiered team of managers and individual contributors; foster a culture of continuous learning, accountability, and psychological safety
- Establish clear organizational structure, governance, and support systems that shield the team from distractions and empower them to execute key strategic initiatives
- Act as a trusted, collaborative partner to Product, Tech, Markets, and Clinical Operations to design, build, and deliver next-generation provider operations capabilities that support aggressive company growth and market expansion targets
- Architect and implement foundational, industry-standard processes and data models that allow the provider data and contracting infrastructure to scale seamlessly alongside the business
- Champion the adoption of industry best practices to ensure all operational processes and internal tools are highly extensible, efficient, and integrated with modern technology stacks
- Lead the team in surface-level and deep-dive diagnostics to identify data, process, and technology bottlenecks. Establish robust KPIs and monitoring dashboards to proactively flag operational issues, leveraging these insights to maintain our standing as a leading health plan
- Identify and execute opportunities for automation (e.g., RPA, AI integrations) across mature, stable workflows to replace manual intervention, reduce turnaround times, and eliminate human error
- Drive administrative expense savings and optimize total cost of care by identifying and executing on process improvements, technical tooling investments, offshore resource optimization, and strategic vendor partnerships
- Guarantee 100% compliance with all applicable state and federal laws, regulatory mandates (e.g., No Surprises Act, CMS requirements), and accreditation standards (NCQA)
- Adapt to evolving business needs by leading critical ad-hoc initiatives and specialized projects as assigned
Skills
- A bachelor's degree or 5+ years of operating experience
- 10+ years of work in operations, health insurance, data analysis and/or consulting
- 5+ years of experience building, coaching and developing operational teams
- 5+ years experience with network operations, provider data management and contracting processes
- 5+ years prior successful experience developing and managing large scale initiatives coordinating with internal and external stakeholders
- 5+ years of experience designing and improving business process for optimization as well as standing up accompanying operating and technical procedures
- 5+ years of experience using data to influence business decisions
- 5+ years of experience program management
- Proven history of managing high-impact initiatives and pitching complex business cases to secure alignment from executive leadership
- Proficiency in SQL, Lean Six Sigma, or other process improvement methodologies
- Deep understanding of data architecture and optimizing data management workflows
- Direct experience operating within service-oriented organizational structures
- Comprehensive knowledge of NCQA credentialing, CMS standards, and the No Surprises Act
- Prior success in deploying or refining enterprise-level MDM or Provider Data Management systems
- Demonstrated ability to apply AI, RPA, or data analytics to improve roster accuracy and processing speed
- Background in leading distributed teams and overseeing external BPO or vendor partnerships
Benefits
- Employee benefits
- Participation in Oscar's unlimited vacation program
- Company equity grants
- Annual performance bonuses
- 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
Company Overview
Company H1B Sponsorship