VP, Clinical Strategy & Integration

Job Description

Job Description

Hi, we're Oscar. We're hiring a VP, Clinical Strategy & Integration.

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 VP of Clinical Strategy & Integration serves as the strategic architect and integration leader for Oscar's Clinical organization. In partnership with the Chief Health Officer, this leader develops, maintains and translates Oscar's clinical strategy into a holistic, member-centric agenda focused on health outcomes, member experience and total cost of care.

This leader brings deep healthcare ecosystem rigor to Oscar's innovation engine, including a sophisticated understanding of payer economics, care delivery, provider and member incentives, utilization patterns, medical cost drivers and the practical realities of changing healthcare behavior. The VP connects clinical strategy to the broader business, ensuring Clinical, Product, Technology, Network, Affordability, Finance, Growth and operations are aligned around a coherent portfolio of clinical capabilities and enterprise priorities.

The VP owns the clinical affordability agenda and the accountability system that turns strategy into measurable results. They identify and prioritize opportunities, architect cross-functional programs, establish clear owners and success measures, and create the governance needed to ensure execution. While functional leaders retain day-to-day ownership of individual workstreams, this leader is accountable for ensuring the overall clinical strategy and affordability portfolio move from intent to action and deliver impact.

You will report into the Chief Health Officer.

Work Location: This position is based in our New York office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid

Pay Transparency: The base pay for this role is: $264,132 - $346,673 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

• "Consumer First" clinical strategy development: Partner with the CHO to develop, maintain and continuously evolve Oscar's clinical strategy, defining how Oscar becomes a more holistic, member-centric organization that manages members across their total cost and experience of care.
• Clinical affordability portfolio: Own the clinical affordability agenda by identifying, sizing and prioritizing opportunities to improve total cost of care while maintaining or improving member outcomes and experience; ensure each initiative has a clear rationale, accountable owner, execution path and measure of success.
• Healthcare ecosystem rigor: Apply a deep understanding of the U.S. healthcare ecosystem, including payer economics, care delivery, provider behavior, benefit and network dynamics, utilization, pharmacy, regulatory constraints and medical cost drivers, to pressure-test strategies and ground innovation in how healthcare actually works.
• Strategic alignment and enterprise integration: Integrate clinical strategy into Oscar's broader business agenda across Product, Technology, Network, Affordability, Finance, Growth, operations and other functions; clarify decision rights, dependencies and tradeoffs required to deliver enterprise objectives.
• Clinical organizational integration and vision: Define how clinical capabilities, including Virtual Care, Case Management, Pharmacy, Utilization Management, Provider Network and Member Experience, should work together as a coherent, end-to-end member experience rather than as disconnected functions.
• Cross-functional program development: Architect and mobilize high-priority cross-functional programs required to realize the clinical strategy and affordability agenda; translate strategic priorities into roadmaps, milestones, owners, dependencies and governance mechanisms.
• Strategy-to-execution accountability: Ensure execution by monitoring progress and outcomes, surfacing risks, resolving cross-functional barriers, escalating decisions when needed and holding leaders accountable for delivery without becoming the tactical owner of every workstream.
• Performance analytics and insights: Establish the performance framework for clinical strategy and affordability, synthesizing clinical, operational, member and financial data into insights that inform priorities, investment decisions, portfolio performance and value realization.
• Technology and capability partnership: Partner with Technology, Product and Clinical leadership to identify the systems, tools, data capabilities and workflows required to support the clinical strategy; prioritize capabilities based on member impact, affordability value, feasibility and scalability.
• Management process and governance: Lead the clinical strategy governance model, including operating cadence, decision forums, portfolio reviews, KPI tracking and executive updates such as Clinical Quarterly Business Reviews.
• People management: Manage and mentor a high-performing team while fostering a culture of healthcare rigor, collaboration, innovation, transparency and accountability.
• Compliance with all applicable laws and regulations 
• Other duties as assigned 

Requirements:

• 15+ years of experience in healthcare industry
• 5+ years experience in managing a large/cross functional end-to-end product teams
• 5+ years managing budget and capacity models

Bonus points:

• 7+ years Managed Care experience in an operations environment
• Experience leading programs tied to clinical outcomes in value based models
• Formal business process/management engineering training

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 us.fitly.work) to make the need for an accommodation known.

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