Senior Director, Operational Excellence

Oscar Health•New York, NY

14h•Hybrid

About The Position

We're hiring a Senior Director, Operational Excellence to join our Insurance Operations team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. You will be a leader and oversee the architectural integrity and performance of Oscar's core insurance service pillars. Reporting to the SVP, Insurance Operations, you will lead a sophisticated organization through four key pillars covering Managed Services, Workforce Management, Process Optimization, and Quality Management. You will design for a "consultant-operator"—someone who pairs a rigorous management consulting background with deep experience running large-scale shared services in a healthcare environment. You will be the primary architect of Oscar's operational engine, ensuring these four different functions work in lockstep to deliver a tech-enabled, seamless member experience. Your mission is to balance rapid scalability with lean efficiency, ensuring that as Oscar grows, our operational quality and member satisfaction remain industry-leading.

Requirements

12+ years of healthcare industry experience, with at least 7 years specifically in a Managed Care operations environment.
8+ years leading Shared Services functions, with a proven track record across BPO, Workforce Management, and Quality Management.
8+ years of strategic leadership, specifically driving cross-functional transformations across Clinical, Product, and Tech/Engineering teams.
7+ years of executive vendor management, with demonstrated success scaling and integrating multi-shore BPO partners.
5+ years of experience as a "manager of managers," overseeing mid-to-senior level leaders and complex matrixed teams.
5+ years of financial accountability, including direct ownership of departmental budgets and high-precision capacity models.
Proven management consulting background (internal or external), with a focus on structured problem-solving and operational frameworks.

Nice To Haves

MBA, MPH or similar preferred
Experience in consulting, either through a top-tier management consulting firm or an internal strategy & operations function.

Responsibilities

Set the organizational tone, strategy, and tenor for the Operational Excellence organization, fostering a culture of high accountability, empathy, and relentless improvement that aligns with Oscar's mission.
Provide strategic direction and horizontal oversight for the four primary operational pillars: Managed Services (BPO/Vendor Mgmt), Workforce Management, Operational Excellence (Process/Execution), and Quality Management.
Directly manage, coach, and enhance a team of leaders of Associate Directors and Directors ensuring cross-functional alignment and breaking down silos between the operational sub-units.
Optimize the shared services model to support Oscar's diverse lines of business, ensuring that centralized resources are deployed with maximum efficiency and high ROI.
Synthesize complex operational data into high-level insights for senior leadership. Simultaneously, craft a compelling vision for the broader organization that drives buy-in, alignment, and a shared sense of purpose across all four pillars.
Apply a management consulting lens to diagnose complex operational friction points within the healthcare payer space, designing end-to-end solutions that improve throughput and member outcomes.
Leverage deep healthcare experience to ensure all operational workflows meet or exceed stringent regulatory requirements (CMS, NCQA) and internal Total Quality Management (TQM) standards.
Oversee the strategy for offshore and outsourced partners, ensuring BPO performance is indistinguishable from internal quality and intergrate into Oscar's culture.
Direct the Workforce Management and Forecasting teams to build high-precision capacity models that account for healthcare seasonality and rapid member growth.
Champion a culture of data-driven process optimization, utilizing Lean or Six Sigma methodologies to drive down the "cost-to-serve" while improving the "quality-to-member."
Act as the lead operational stakeholder for Product and Engineering teams, translating operational pain points into technical requirements for internal tool development.
Manage a significant operational budget and provide the SVP, Insurance Operations with clear, data-backed visibility into the health, scalability, and financial performance of the organization.
Compliance with all applicable laws and regulations
Other duties as assigned