Director, Provider Operations

About the Role

The Director of Provider Operations builds, scales, and optimizes Oscar’s provider data management, contracting, and credentialing processes. This role sets the vision and strategy for provider operations and data functions, and designs processes that improve Oscar’s ability to serve members and providers. You will work cross‑functionally with partners and stakeholders to transform ideas from vision to implementation.

You will report into the Vice President of Network Operations.

Work Location

This position is based in our Tempe, Arizona office. It requires a hybrid work schedule with three days of in‑office work per week. Thursdays are a required in‑office day for team meetings and events, while your other two office days are flexible.

Pay Transparency

The base pay for this role is: $147,549—$193,658 per year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program, company equity grants, and annual performance bonuses.

• Medical, dental, and vision benefits
• 11 paid holidays
• Paid sick time
• Paid parental leave
• 401(k) plan participation
• Life and disability insurance
• Paid wellness time and reimbursements

Responsibilities

Strategic Leadership & Team Development

• Provide strategic leadership and operational oversight for the end‑to‑end provider data lifecycle, ensuring precise and timely execution of provider credentialing, contract loading, and daily data management.
• Lead, coach, and develop a high‑performing, multi‑tiered team of managers and individual contributors; foster a culture of continuous learning, accountability, and psychological safety.
• Establish clear organizational structure, governance, and support systems that shield the team from distractions and empower them to execute key strategic initiatives.
• Act as a trusted, collaborative partner to Product, Tech, Markets, and Clinical Operations to design, build, and deliver next‑generation provider operations capabilities that support aggressive company growth and market expansion targets.

Operational Excellence & Scalability

• Architect and implement foundational, industry‑standard processes and data models that allow the provider data and contracting infrastructure to scale seamlessly alongside the business.
• Champion the adoption of industry best practices to ensure all operational processes and internal tools are highly extensible, efficient, and integrated with modern technology stacks.
• Lead the team in surface‑level and deep‑dive diagnostics to identify data, process, and technology bottlenecks. Establish robust KPIs and monitoring dashboards to proactively flag operational issues, leveraging these insights to maintain our standing as a leading health plan.

Efficiency, Automation & Compliance

• Identify and execute opportunities for automation (e.g., RPA, AI integrations) across mature, stable workflows to replace manual intervention, reduce turnaround times, and eliminate human error.
• Drive administrative expense savings and optimize total cost of care by identifying and executing on process improvements, technical tooling investments, offshore resource optimization, and strategic vendor partnerships.
• Guarantee 100% compliance with all applicable state and federal laws, regulatory mandates (e.g., No Surprises Act, CMS requirements), and accreditation standards (NCQA).
• Adapt to evolving business needs by leading critical ad‑hoc initiatives and specialized projects as assigned.

Requirements

• A bachelor’s degree or 5+ years of operating experience
• 10+ years of work in operations, health insurance, data analysis, and/or consulting
• 5+ years of experience building, coaching, and developing operational teams
• 5+ years of experience with network operations, provider data management, and contracting processes
• 5+ years of prior successful experience developing and managing large‑scale initiatives coordinating with internal and external stakeholders
• 5+ years of experience designing and improving business processes for optimization as well as standing up accompanying operating and technical procedures
• 5+ years of experience using data to influence business decisions
• 5+ years of experience program management

Bonus Points

• Proven history of managing high‑impact initiatives and pitching complex business cases to secure alignment from executive leadership.
• Proficiency in SQL, Lean Six Sigma, or other process improvement methodologies
• Deep understanding of data architecture and optimizing data management workflows
• Direct experience operating within service‑oriented organizational structures
• Comprehensive knowledge of NCQA credentialing, CMS standards, and the No Surprises Act.
• Prior success in deploying or refining enterprise‑level MDM or Provider Data Management systems.
• Demonstrated ability to apply AI, RPA, or data analytics to improve roster accuracy and processing speed.
• Background in leading distributed teams and overseeing external BPO or vendor partnerships.

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.

Artificial Intelligence (AI)

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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 ( ) to make the need for an accommodation known.

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