Market Medical Officer

This is a fully remote position, open to applicants in Arizona, +15 more states.

📋 Description

• Drive the performance of essential clinical metrics for managing regional trends and market performance.

• Collaborate with Medical Economics to pinpoint utilization trends and devise strategies to lower overall expenditures.

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

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

• Lead clinical initiatives alongside Network Contracting leadership to improve provider alignment, care quality, and clinical outcomes.

• Identify and address regional network gaps and access challenges.

• Work with regulatory agencies and compliance teams on network adequacy and quality improvement programs.

• Convert policy changes into operational strategies that safeguard member access and enhance organizational performance.

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

• Report directly to the VP of Clinical Affairs.

• Perform additional responsibilities as assigned.

⛳️ Requirements

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

• A minimum of 10 years of experience in managed care, with prior leadership experience in a matrix environment.

• At least 7 years of clinical leadership experience in a market-specific role.

• More than 7 years of experience managing clinical market trends in health insurance or full risk-bearing clinical provider organizations.

• 5 or more years of clinical practice experience.

• Board certification in internal medicine, family medicine, general surgery, emergency medicine, or another recognized specialty.

• A minimum of 5 years of experience leading teams.

• An MD or DO with a current unrestricted medical practice license in a state within the region is required.

• Maintain necessary credentials, including active board certification.

• Willingness and ability to obtain additional state licensure with support from Oscar.

• Adherence to applicable laws and regulations.

🏝️ Benefits

• Comprehensive employee benefits.

• Unlimited vacation program.

• Company equity grants.

• Annual performance bonuses.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 11 paid holidays.

• Paid sick time.

• Paid parental leave.

• Participation in a 401(k) plan.

• Life and disability insurance.

• Paid wellness time and reimbursements.

• Occasional travel for team meetings and company events.