Market Medical Officer

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

📋 Description

• Act as the clinical executive for the Atlantic region

• Collaborate with P&L leadership to drive market performance, broaden care access, and improve affordability

• Enhance medical cost trends and reimbursement strategies

• Implement regional programs and connect corporate operations with local provider leadership

• Propel key clinical metrics for trend management and regional plan performance

• Detect utilization trends and create solutions to lower overall spending

• Establish partnerships with health systems, physician groups, and community providers

• Collaborate with Affordability, Utilization Management, Care Management, Claims, and other internal teams

• Lead clinical initiatives that improve provider alignment, care quality, and clinical outcomes

• Address network gaps and access obstacles

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

• Convert policy changes into operational strategies

• Manage regional escalations, appeals, grievances, and complex case management scenarios

• Report directly to the Vice President of Clinical Affairs

⛳️ Requirements

• Over 12 years of progressive leadership experience in the healthcare sector

• More than 10 years of experience in managed care with prior leadership in a matrix environment

• At least 7 years of clinical leadership experience in the relevant market

• Minimum of 7 years managing clinical market trends in health insurance or full-risk-bearing clinical provider groups

• 5+ years of clinical practice required

• Board certification in internal medicine, family medicine, general surgery, or emergency medicine; other specialties may be considered

• Over 5 years of experience in team leadership

• An MD or DO with a current unrestricted medical license in a state within the region (GA, NC, SC, NJ, NY, PA, VA) is mandatory

• Must maintain necessary credentials, including active board certification

• Willingness and ability to obtain additional state licensure

• Adherence to all applicable laws and regulations

🏝️ Benefits

• 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 401(k) plan

• Life insurance

• Disability insurance

• Paid wellness time

• Wellness reimbursements

• Oscar's support for acquiring additional state licensure