Director, Pharmacy Operations Strategy & Integration

Oscar Health•Dallas, TX

2d•Remote

About The Position

Oscar is hiring a Director, Pharmacy Operations Strategy & Integration to shape and execute the pharmacy operational excellence agenda for its Pharmacy Clinical Strategy and Operations area. Reporting to the SVP, Pharmacy, the role translates strategic priorities into operating-model improvements, cross-functional programs, vendor capabilities, and scalable workflows that advance affordability, health outcomes, and member and provider experience. The Director connects Pharmacy, Clinical, Product, Engineering, Finance, Actuarial, Concierge, Compliance, and PBM/vendor partners to align priorities, decisions, and execution, while balancing affordability, experience, regulatory compliance, operational quality, and scalability. This is a fully remote position open to candidates residing in Dallas, Texas. Oscar notes that its approach to work may adapt over time and could potentially involve a hybrid presence at the hub office associated with the candidate’s metro area. The base pay range is $162,453.60–$213,220.35 per year. The role is eligible for employee benefits, Oscar’s unlimited vacation program, company equity grants, and annual performance bonuses.

Requirements

10+ years of experience in healthcare, business operations, strategy and operations, product operations, or program leadership.
7+ years of Managed Care, PBM, pharmacy operations, clinical operations, or related healthcare payer experience.
5+ years leading large-scale, cross-functional strategy, operational transformation, or implementation initiatives from opportunity definition through launch and adoption.
5+ years partnering directly with cross-functional business, Product, Engineering, vendor, or operations teams to set priorities, define requirements, influence solutions, and deliver business outcomes.
Experience interpreting regulatory, compliance, operational, or contractual business needs and translating them into actionable requirements for cross-functional partners.
Experience with strategic planning, roadmapping, business analysis, operational readiness, change management, and translating priorities into executable cross-functional plans.
Experience translating complex operational data and performance information into executive-level insights, recommendations, and governance materials.
Experience managing budgets, capacity models, business cases, or financial performance for operational or transformation initiatives.

Nice To Haves

MBA, MPH, or a master’s degree in Business Administration or a related field.
Management consulting, internal strategy and operations, process engineering, Lean, Six Sigma, or similar structured problem-solving experience.
Experience with PBM implementation, pharmacy benefit administration, claims adjudication, formulary operations, prior authorization, rebate/formulary systems, or healthcare data feeds.
Experience working in matrixed teams through enterprise transformation, implementation, or operational excellence work.

Responsibilities

Set the pharmacy operational excellence strategy, operating rhythm, and execution model, aligning priorities with Oscar’s enterprise agenda, Pharmacy objectives, affordability goals, and member and provider outcomes.
Lead high-priority pharmacy operational transformation initiatives from strategy through execution, including opportunity definition, roadmap development, operational readiness, launch planning, and sustained adoption.
Partner across internal and external teams to translate pharmacy and PBM opportunities, member and provider needs, and frontline insights into priorities, decisions, and measurable outcomes.
Stay informed about applicable PBM, pharmacy benefit, managed care, and healthcare regulatory requirements; interpret business needs and communicate them so solutions are appropriately designed and implemented.
Maintain an understanding of the pharmacy and healthcare ecosystem, including payer economics, benefit and network dynamics, claims processes, formulary operations, prior authorization workflows, utilization patterns, vendor handoffs, and affordability and experience drivers.
Partner with internal stakeholders and external vendors on implementation plans, business reviews, strategic meetings, issue escalation, performance monitoring, and operational integration.
Coordinate across Clinical, Pharmacy Operations, Product, Engineering, Finance, Actuarial, Concierge, Compliance, and vendor partners to align decision rights, dependencies, tradeoffs, and delivery plans.
Diagnose process, data, technology, and vendor friction points and design end-to-end solutions that improve throughput, quality, affordability, and member and provider experience.
Partner with Pharmacy, Clinical, Product, Engineering, Concierge, and vendor teams to identify member and provider experience friction and develop scalable, measurable improvements across pharmacy journeys.
Lead governance and executive reporting for pharmacy operational excellence initiatives, translating operational, member, provider, clinical, and financial data into priorities, recommendations, and accountability for senior leadership.
Identify and manage implementation risks, dependencies, decisions, and change-management needs, ensuring stakeholders understand scope, impact, tradeoffs, and operational readiness requirements.
Build repeatable operating playbooks, process standards, controls, and best practices for a scalable PBM operating model, continuous improvement, and a coherent end-to-end pharmacy experience.
Use independent judgment to resolve complex problems, evaluate variable factors, and determine appropriate approaches to technology-enabled process improvement and operational transformation.
Support capacity planning, budget management, business-case development, and value-realization measurement for PBM, vendor, and operational excellence initiatives.
Ensure operational workflows, vendor capabilities, and program execution meet applicable regulatory, compliance, quality, and contractual requirements.
Comply with all applicable laws and regulations.
Perform other duties as assigned.