Director, Provider Operations

Job Description

Job Description

Hi, we're Oscar. We're hiring a Director to join our Provider Operations team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Director, Provider Operations builds, scales and optimizes Oscar's provider data management, contracting, and credentialing processes. This role is responsible for setting the vision and strategy for provider operations and data functions, and designing processes that improve Oscar's capabilities in serving members and providers. The role does this by working with partners and stakeholders cross-functionally to take ideas from vision to implementation.

You will report into the Vice President, Network Operations.

Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

Pay Transparency: The base pay for this role is: $147,549 - $193,658 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

Strategic Leadership & Team Development

• 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.

Operational Excellence & Scalability

• 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.

Efficiency, Automation & Compliance

• 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.

Requirements:

• 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

Bonus points:

• 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.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (View email address on ziprecruiter.com) to make the need for an accommodation known.

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