Director, Pharmacy Operations Strategy & Integration

Oscar Health•Tempe, AZ

2d•Hybrid

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. 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. It balances enterprise affordability, experience, regulatory compliance, operational quality, and long-term scalability as Oscar develops its pharmacy operating model. The Director is a connective leader across Pharmacy, Clinical, Product, Engineering, Finance, Actuarial, Concierge, Compliance, and PBM/vendor partners, aligning priorities, decisions, and execution to deliver measurable business impact. The position reports to the SVP, Pharmacy and is based in Oscar’s Tempe, Arizona office on a hybrid schedule: three office days each week, including Thursdays, with the other two office days flexible.

Requirements

10 or more years of experience in healthcare, business operations, strategy and operations, product operations, or program leadership.
7 or more years of Managed Care, PBM, pharmacy operations, clinical operations, or related healthcare payer experience.
5 or more years leading large-scale, cross-functional strategy, operational transformation, or implementation initiatives from opportunity definition through launch and adoption.
5 or more 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, 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 on 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 with internal and external teams to translate pharmacy and PBM opportunities, member and provider needs, and frontline insights into clear priorities, decisions, and measurable outcomes.
Stay informed about applicable PBM, pharmacy benefit, managed care, and healthcare regulatory requirements, and communicate business needs clearly so solutions are designed and implemented appropriately.
Maintain a deep 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 to manage 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 practical 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 journey friction points and turn insights into scalable, measurable improvements.
Lead governance and executive reporting for pharmacy operational excellence initiatives, synthesizing operational, member, provider, clinical, and financial data into priorities, recommendations, and senior-leadership accountability.
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 to support 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 courses of action for 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.