Medical Director Scientific Affairs

Oscar Health•Atlanta, GA

2d•$237,719 - $312,006•Remote

About The Position

The Medical Director, Scientific Affairs provides strategic leadership to the Clinical Policy team, ensuring medical and pharmacy policies are rigorously evidence-based and aligned with current clinical advancements. This role manages the full policy lifecycle, from literature evaluation to final execution. The Medical Director, Scientific Affairs directs Oscar Health's clinical publishing efforts, and serves as a cross-functional scientific authority across the organization. You will report into our Vice President, Clinical Affairs.

Requirements

10+ years working in relevant fields
6+ years clinical policy experience in health insurance, PBM, or other clinical guideline development organization
4+ years experience in clinical policy drafting and development
4+ Years of experience leading, chairing, or facilitating multi-disciplinary clinical committees or advisory subcommittees
4+ years publishing in relevant fields
3+ years of experience communicating with executives and interacting with all levels of the organization
3+ years of leadership experience as a people manager
1+ years of experience with medical coding terminologies (HCPCs, CPT, ICD-10)
Medical Degree (MD or DO): Required from an accredited school of medicine or osteopathic medicine
Board Certification: Active board certification recognized by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA).

Nice To Haves

Demonstrated experience analyzing clinical trials and medical literature.
A track record of publishing in peer-reviewed clinical journals or serving on an Institutional Review Board (IRB) or Clinical Practice Guideline panel is highly desirable
PhD or Masters in Clinical Research

Responsibilities

Serve as the primary evidence-based subject matter expert, translating clinical research into actionable strategies to elevate care quality across the organization.
Lead the research, development, revision, and clinical accuracy of all medical, utilization management (UM), and pharmacy coverage policies.
Advise executive leadership on emerging medical therapies, complex clinical trends, and population health utilization patterns using data-driven insights.
Support the development of clinical and lifestyle products through the production of evidence based research tailored to target populations.
Foster academic partnerships to advance and publish clinical research leveraging health plan population data.
Lead the systematic review of major specialty society guidelines (e.g., ASCO, ACC, AACE), ensuring policies reflect established standards of care and objective evidence evaluation.
Establish, maintain, and enforce the formal framework for grading clinical evidence, ensuring all medical and pharmacy policies are anchored in high-quality, peer-reviewed literature.
Oversee Clinical Advisory Subcommittees - setting agendas, presenting clinical evidence packages, and driving expert consensus to guide policy decisions.
Partner with Pharmacy Services (P&T Committee), Legal, and Compliance to seamlessly integrate coverage policies that meet or exceed NCQA standards and state/federal mandates.
Support interactions with federal and state regulatory bodies (e.g., FDA, CMS, State DOIs) as needed.
Compliance with all applicable laws and regulations.
Other responsibilities as assigned.