Market Medical Officer

This is a fully remote position, open to applicants in Arizona, +7 more states.

📋 Description

• Lead the performance of essential clinical metrics for managing trends and overseeing regional plan performance in collaboration with market P&L leadership.

• Recognize market-based utilization patterns and create strategies to minimize overall expenditures.

• Establish strategic alliances with health systems, physician networks, and community healthcare providers.

• Act as the regional clinical liaison across Affordability, Utilization Management, Care Management, Claims, and other internal departments.

• Collaborate with Network Contracting leadership to ensure provider alignment, enhance care quality, and improve clinical outcomes.

• Identify and address regional network deficiencies and access challenges.

• Work together with regulatory bodies and compliance teams on network adequacy and quality initiatives.

• Convert policy alterations into proactive operational approaches.

• Handle regional escalations, including appeals, grievances, and complex case management situations.

• Execute additional duties as required.

⛳️ Requirements

• Minimum of 12 years of progressive leadership experience within the healthcare sector.

• At least 10 years of experience in managed care, with prior leadership roles in a matrix environment.

• A minimum of 7 years of clinical leadership experience in the specific market.

• Over 7 years of experience in managing clinical market trends within health insurance or full risk-bearing clinical provider groups.

• A minimum of 5 years of clinical practice experience.

• Board certification in internal medicine, family medicine, general surgery, emergency medicine, or a related field is required.

• At least 5 years of experience in leading teams.

• MD or DO with a current unrestricted medical practice license in a state within the region (TX, AZ, MO, OK) is required.

• Must maintain necessary credentials and active board certification.

• Willingness and capability to obtain additional state licensure.

• Compliance with all relevant laws and regulations is essential.

🏝️ Benefits

• Comprehensive employee benefits package.

• Unlimited vacation program.

• Equity grants from the company.

• Annual performance bonuses.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• 11 paid holidays per year.

• Paid sick leave.

• Paid parental leave.

• Participation in a 401(k) plan.

• Life insurance options.

• Disability insurance coverage.

• Paid wellness time and reimbursements.

• Support from Oscar for obtaining additional state licensure.