Director, Pharmacy Operations Strategy & Integration

Oscar Health•Tempe, AZ

2d•$162,454 - $213,220•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 aligns priorities, decisions, and execution across Pharmacy, Clinical, Product, Engineering, Finance, Actuarial, Concierge, Compliance, and PBM/vendor partners, balancing affordability, experience, regulatory compliance, operational quality, and long-term scalability. The Director reports to the SVP, Pharmacy and is based in Oscar’s Tempe, Arizona office on a hybrid schedule, with three in-office days per week. Thursdays are required in-office; the other two office days are flexible. The stated base pay range is $162,453.60–$213,220.35 per year, with eligibility for employee benefits, unlimited vacation, 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 on enterprise transformation, implementation, or operational excellence work.

Responsibilities

Set the pharmacy operational excellence strategy, operating rhythm, and execution model in alignment with enterprise priorities, Pharmacy objectives, affordability goals, and member and provider outcomes.
Lead high-priority pharmacy operational transformation initiatives from opportunity definition through 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.
Monitor applicable PBM, pharmacy benefit, managed care, and healthcare regulatory requirements, and communicate requirements to partners so solutions are appropriately designed and implemented.
Maintain understanding of the pharmacy and healthcare ecosystem, including payer economics, benefit and network dynamics, claims, formulary operations, prior authorization, utilization, vendor handoffs, 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 vendors 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 relevant teams to identify member and provider experience friction points and develop scalable, measurable improvements across pharmacy journeys.
Lead governance and executive reporting by synthesizing 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, communicating scope, impact, tradeoffs, and readiness requirements.
Build repeatable operating playbooks, process standards, controls, and best practices for a scalable PBM operating model, continuous improvement, and coherent pharmacy experience.
Use independent judgment to resolve complex problems 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 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.