Hi, we're Oscar. We're hiring a Director of Case Management Operations to join our Clinical Care team.
Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.
About the roleYou will drive and oversee the Case Management team's business strategy, program design, and outcomes. You will be accountable to program success, and the financial performance of the department, both from an administrative efficiency and affordability standpoint. You will direct and influence teams involved in building net-new programs, and optimizing existing Case Management programs to deliver medical cost savings to Oscar, and healthier outcomes to its members.
You will report to the Senior Director, Virtual Care
Work Location:
Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.
If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.
You must reside in one of the following states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote
Pay Transparency:
The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $174,400 - $228,900 per year. The base pay for this role in all other locations is: $156,960 - $206,010 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants, and annual performance bonuses.
Responsibilities- Define and execute the Case Management strategy to drive affordability outcomes
- Lead program design, pilots, and measurement for initiatives like TOC, polypharmacy, and pre-ESRD
- Manage a team of program managers with clear accountability for ROI and operational performance
- Build scalable playbooks and processes for trend management and program expansion
- Conduct prioritization, cost-benefit analysis, and business case development
- Partner with analytics, actuarial, and finance teams to track MLR and PMPM impact
- Oversee departmental budgeting and performance evaluation
- Act as a thought leader and stay informed on market trends
- Collaborate across teams to operationalize initiatives and drive results
- Lead strategic initiatives and prepare executive-level communications
- Compliance with all applicable laws and regulations
- Other duties as assigned
- Clinical background (PharmD, BSPharm, RN, LCSW, or similar) with strong clinical fluency
- 10+ years in healthcare strategy/operations; 6+ years in people management with outcome ownership
- 5+ years designing and scaling care delivery programs—especially Case Management, ideally in a payor setting
- 3+ years in Case Management or Population Health focused on affordability and MLR impact
- Experience leading large, cross-functional initiatives across clinical, analytics, and actuarial teams
- Strong analytical and financial acumen; proficient in Excel/Google Sheets and ROI modeling
- Executive-level communication and influence skills
- Structured, consultative approach; comfortable with ambiguity and tradeoff evaluation
- MPH or MBA
- Experience in management consulting, particularly in healthcare strategy
- Experience working in a growth-stage healthcare or health tech company
- Background in delivering programs for ACA populations, including challenges related to engagement, comorbidities, and cost drivers
- Familiarity with risk adjustment, medical loss ratio (MLR) levers, and per-member/per-month (PMPM) affordability tracking
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.
Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([email protected]) to make the need for an accommodation known.
Artificial Intelligence (AI) Guidelines: Please see our AI Guidelines for the acceptable use of artificial intelligence during the interview process at Oscar.
California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Notice to Job Applicants.
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What We Do
Health care is broken; we're trying to fix it. The Oscar team is focused on utilizing technology, design and data to humanize health care. We're a group of technology and health care professionals who looked at the current state of the US health care system, got frustrated by the horrible consumer experience, and decided to do something big about it. Backed by a renowned set of investors and advisors, we’ve set out to revolutionize health care.
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