Market Medical Officer, Central
New
O
OscarHealth Insurance
This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories.Full-TimeExecutive
SalaryThe base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $290,628- $381,449 per year. The base pay for this role in all other locations is: $261,565 - $343,304 per year.
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Job Details
- Experience
- 12+ years of progressive leadership experience in healthcare.
- Required Skills
- Risk Management
Requirements
- MD or DO degree.
- Current unrestricted license to practice medicine in a state within the Central region (Illinois, Indiana, Michigan, Ohio, Iowa, Kansas, Nebraska).
- Active board certification.
- 12+ years of progressive leadership experience in healthcare.
- 10+ years of experience in managed care with prior experience leading in a matrix environment.
- 7+ years of clinical leadership experience in a market-specific role.
- 7+ years of experience managing clinical market trends in health insurance or full risk-bearing clinical provider groups.
- 5+ years of clinical practice experience.
- 5+ years of experience leading teams.
- Board certified in internal medicine, family medicine, general surgery, or emergency medicine (other fields considered).
- Willingness to obtain additional state licensure.
Responsibilities
- Drive performance of key clinical metrics for trend management and market performance of plans in the region.
- Identify market-based utilization trends and develop solutions to reduce overall medical spend in partnership with Med Econ.
- Build strategic partnerships with health systems, physician groups, and community providers to align incentives.
- Serve as the regional clinical partner across internal teams including Affordability, Utilization Management, Care Management, and Claims.
- Partner with Network Contracting leadership to guide clinical initiatives that enhance provider alignment and clinical outcomes.
- Resolve regional network gaps and access barriers to advance quality care for member populations.
- Ensure regional network adequacy and quality programs comply with state and federal regulatory requirements.
- Serve as the point of accountability for regional escalations, appeals, grievances, and complex case management.
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