VP, Provider Integration & Experience

Hi, we're Oscar. We're hiring a VP, Provider Integration & Experience to join our Provider Operations & Experience 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 Vice President of Provider Integration and Experience is responsible for driving the overall provider experience strategy, designing operational solutions, and leading the enterprise operating model for escalated provider issue resolution. This position owns the provider journey, developing and executing cross-functional roadmaps to proactively reduce friction while overseeing a world-class, multi-disciplinary escalation management organization.

Reporting directly to executive leadership, this role serves as the principal advocate for providers serving Oscar members. By partnering closely with senior leaders across Claims, Network, Utilization Management, Payment Integrity, Contact Center, Clinical Services and Technology, the Vice President will translate data-driven insights into systemic, root-cause remediations that maximize network satisfaction and deliver high-impact enterprise ROI.

You will report into the SVP, Provider Operations & Experience.

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: $240,120 - $315,158 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

• Act as the primary internal and external voice and champion for the provider experience.
• Shape the overarching Oscar Provider Experience strategy, creating a long-term vision to be an easy and dependable partner to providers.
• Develop deep, analytical frameworks and measures to assess the health of the provider experience and evaluate its overall impact on Oscar’s broader network.
• Maintain deep healthcare market and competitor intelligence, keeping a pulse on regulatory changes, vendor innovations, and emerging operational models.
• Build and scale the operating model for escalated provider issues, establishing standardized intake criteria, triage pathways, and closure expectations.
• Oversee the swift resolution of urgent, high-complexity, or high-profile provider escalations that span multiple cross-functional departments.
• Foster strong strategic relationships with Subject Matter Experts (SMEs) and senior functional leaders across Claims, Network, Utilization Management, Payment Integrity, and Technology to streamline operational handoffs and secure resources for systemic fixes.
• Drive organizational change management, ensuring successful cross-functional adoption of new operational models, workflow metrics, and provider-centric behaviors.
• Leverage robust operational data, analytics, and ROI assessments to identify systemic root causes of provider friction and prioritize technical or operational resolutions.
• Establish tracking mechanisms to guarantee that once a root cause is identified, systemic fixes are fully implemented and verified across strategic accounts.
• Manage the settlements and independent dispute resolution processes with legal and other business support teams
• Create and deliver executive-ready reporting, interactive dashboards, and strategic recommendations to senior leadership and board members regarding operational health, system trends, and critical blockers.
• Empower and mentor a senior-level team, aligning their personal growth with the delivery of high-impact organizational outcomes.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• A bachelor's degree or commensurate 4 years of experience
• 15+ years of professional experience in healthcare operations, payer operations, network operations, strategic planning, healthcare consulting, or provider relations
• 7+ years of experience collaborating, influencing, and driving strategic alignment at the executive level (SVP, EVP, and C-Suite).
• 7+ years of direct senior leadership experience, specifically managing multi-team functions, managers, and directors.
• Deep technical understanding of payer operations, including claims administration, provider data, reimbursement methodologies, utilization management, payment integrity, and provider relations workflows.
• Demonstrated experience building operational models, SLA frameworks, and governance structures in ambiguous environments.

Bonus points:

• Master’s degree from a top-tier program in Business Administration (MBA), Health Administration (MHA), Public Health (MPH), or a closely related field.

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