Market Medical Officer, Atlantic

Oscar Health•Remote, GA

4d•$261,565 - $381,449•Remote

About The Position

Oscar is hiring a Market Medical Officer to serve as the clinical executive for the Atlantic region. The role partners with P&L leadership to lead market performance, expand care access, and enhance affordability. It optimizes medical cost trends and reimbursement strategies while balancing financial sustainability with plan performance. As the primary clinical liaison for the region, the officer executes regional programs and connects corporate operations with local provider leadership. The position reports to the Vice President, Clinical Affairs. It is fully remote for candidates residing in Georgia, North Carolina, South Carolina, New Jersey, New York, Pennsylvania, or Virginia. Work is performed from a home office, with occasional travel for team meetings and company events. The role requires an MD or DO, an active unrestricted medical license in a state in the region, and maintenance of active board certification.

Requirements

12 or more years of progressive leadership experience in healthcare.
10 or more years of experience in managed care, including prior leadership in a matrix environment.
7 or more years of clinical leadership experience in the relevant 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: Georgia, North Carolina, South Carolina, New Jersey, New York, Pennsylvania, or Virginia.
Maintain the credentials necessary 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.
A 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 Medical Economics to identify market utilization trends and flares and develop solutions to address key cost drivers.
Build strategic partnerships with health systems, physician groups, and community providers to align incentives and lower the total cost of care.
Serve as the regional clinical partner across internal teams, including Affordability, Utilization Management, Care Management, and Claims, to advance regional performance goals.
Partner with Network Contracting leadership on clinical initiatives that improve provider alignment, care quality, and clinical outcomes.
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 meet state and federal requirements, and translate policy changes into operational strategy.
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.