Market Medical Officer, Central
About The Position
Oscar is hiring a Market Medical Officer for the Central region as part of its Clinical Affairs team. The role serves as the region’s clinical executive, partnering with P&L leadership to drive market performance, expand care access, and improve affordability. It optimizes medical cost trends and reimbursement strategies while balancing financial sustainability with plan performance. As the primary clinical liaison, the officer executes regional initiatives and connects corporate operations with local provider leadership. The position reports to the VP of Clinical Affairs. The role is fully remote for candidates residing in Illinois, Indiana, Michigan, Ohio, Iowa, Kansas, or Nebraska. Work is completed from a home office, with occasional travel for team meetings and company events.
Requirements
- 12 or more years of progressive leadership experience in healthcare.
- 10 or more years of experience in managed care, including prior experience leading in a matrix environment.
- 7 or more years of clinical leadership experience in the role-specific market.
- 7 or more years of experience managing clinical market trends in health insurance or full-risk-bearing clinical provider groups.
- 5 or more years of clinical practice and board certification in internal medicine, family medicine, general surgery, or emergency medicine; other fields will be considered.
- 5 or more years of experience leading teams.
- MD or DO degree and a current unrestricted license to practice medicine in a state in the region: Illinois, Indiana, Michigan, Ohio, Iowa, Kansas, or Nebraska.
- Maintain the credentials needed for the position, including active board certification.
- Willingness and ability to obtain additional state licensure, with Oscar's support.
Nice To Haves
- P&L experience for a risk-bearing entity.
- Licensure in multiple Oscar states.
- Master's degree or advanced certificate.
- Prior experience with Utilization Management.
Responsibilities
- Drive performance of key clinical metrics for trend management and regional plan performance, including ED/K, APK, and ALOS, in partnership with market P&L leadership.
- Partner with Med Econ to identify market-based utilization trends and flares and develop solutions to address key drivers and reduce overall spend.
- Build strategic partnerships with health systems, physician groups, and community providers to align incentives and lower the total cost of care.
- Serve as a regional clinical partner across internal teams, including Affordability, Utilization Management, Care Management, and Claims, to drive regional performance goals.
- Partner with Network Contracting leadership to guide clinical initiatives that improve provider alignment, care quality, and clinical outcomes across the region.
- Identify and resolve regional network gaps and access barriers to advance equitable, high-quality care across member populations.
- Collaborate with regulatory agencies and compliance teams to ensure regional network adequacy and quality programs comply with state and federal requirements, and translate policy changes into operational strategy that protects member access and organizational performance.
- Be accountable for regional escalations, including internal and external appeals, provider and member grievances, and complex case management scenarios.
- Comply with all applicable laws and regulations.
- Perform other responsibilities as assigned.
Benefits
- Employee benefits.
- Participation in Oscar's unlimited vacation program.
- Company equity grants.
- Annual performance bonuses.
- Medical, dental, and vision benefits.
- 11 paid holidays.
- Paid sick time.
- Paid parental leave.
- 401(k) plan participation.
- Life and disability insurance.
- Paid wellness time and reimbursements.
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What This Job Offers
Job Type
Full-time
Career Level
Executive
Education Level
Ph.D. or professional degree
