Back to jobs

Senior Director, Escalated Provider Issue Resolution

Tempe, Arizona, United States

Hi, we're Oscar. We're hiring a Senior Director, Escalated Provider Issue Resolution to join our Network & Provider Management team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless 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 role:

The Senior Director, Escalated Provider Issue Resolution team supports strategic provider accounts, high-complexity escalations, root-cause remediation, and provider service governance. This role will build and scale the operating model for escalated provider issue resolution, lead a multi-disciplinary team, and partner across Claims, Network, Utilization Management, Payment Integrity, Contact Center, Account Management, Technology, Analytics, and senior leadership to improve how Oscar identifies, routes, resolves, and prevents provider issues. This position will report to the SVP, Network and Provider Management.

You will report into the Vice President of Provider Integration & Experience.

Work Location: This position is based in our Tempe, Arizona office, requiring a hybrid work schedule with 3 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 to suit your schedule. #LI-Hybrid

Pay Transparency: The base pay for this role is: $196,732 - $258,211 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

  • Lead and develop a multi-disciplinary provider issue resolution organization, including teams focused on strategic provider support, complex issue resolution, root-cause remediation, and provider service governance.
  • Build a scalable operating model for escalated provider issues, including intake standards, triage criteria, escalation pathways, ownership expectations, service metrics, and closure practices.
  • Oversee resolution of high-impact provider issues that require coordination across multiple operational teams.
  • Partner with leaders across Claims, Network, Utilization Management, Payment Integrity, Contact Center, Account Management, Technology, and Analytics to improve handoffs, reduce avoidable escalations, and address recurring root causes.
  • Oversee root-cause remediation by analyzing escalated issue trends, prioritizing fixes based on provider impact and enterprise ROI, and driving cross-functional follow-through on the highest-value operational improvements.
  • Establish closed-loop tracking to ensure identified root causes are addressed, operational fixes are adopted, and improvements reduce recurring provider friction across strategic accounts and the broader provider network.
  • Create executive-ready reporting on provider issue trends, operational health, risks, blockers, and decisions needed.
  • Serve as a senior escalation leader for urgent, complex, or high-profile provider issues.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • 12+ years of experience in healthcare operations, provider operations, payer operations, claims operations, network operations, provider relations, or a related field.
  • 7+ years of senior leadership experience, including experience leading managers or multi-team operational functions.
  • Experience leading complex issue resolution, escalation management, operational transformation, or service model design in a healthcare environment.
  • Strong understanding of payer operations, including claims, provider data, network operations, reimbursement, utilization management, payment integrity, and provider service workflows.
  • Proven ability to build operating models, governance routines, performance metrics, and accountability mechanisms across multiple teams.
  • Experience leading change management and adoption for new operating models across cross-functional teams.
  • Strong analytical, executive communication, and stakeholder management skills.
  • Comfort operating in ambiguity and building new functions, teams, and processes.
  • Ability to quickly understand and operate within new technical systems and workflows.

Bonus points:

  • Experience standing up or transforming provider service, escalation, claims resolution, issue management, or operational governance functions.
  • Experience supporting strategic provider relationships, large health systems, or high-profile provider escalations.
  • Experience with Jira, Salesforce, ServiceNow, Zendesk, or similar workflow management tools.
  • Experience building dashboards, SLA reporting, operational performance reporting, or issue-resolution analytics.
  • Advanced Excel, SQL, or data analysis experience.

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.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

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 (accommodations@hioscar.com) to make the need for an accommodation known.

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 Privacy Policy.

Create a Job Alert

Interested in building your career at Oscar Health? Get future opportunities sent straight to your email.

Apply for this job

*

indicates a required field

Resume/CV*

Accepted file types: pdf, doc, docx, txt, rtf

Cover Letter

Accepted file types: pdf, doc, docx, txt, rtf

Select...
Select...
Select...

The work location expectations for this role is listed in the job postings under “Work Location”. This section includes any onsite related expectations and residency requirements.

Oscar Health is authorized to do business in many, but not all, states. If you are not located in or willing to relocate to a state where Oscar is registered, you will not be eligible for employment. The approved states for this role are listed in the job posting.

Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey. Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file.

As set forth in Oscar Health’s Equal Employment Opportunity policy, we do not discriminate on the basis of any protected group status under any applicable law.

Select...
Select...
Race & Ethnicity Definitions

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection. As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categories is as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

Select...

Voluntary Self-Identification of Disability

Form CC-305
Page 1 of 1
OMB Control Number 1250-0005
Expires 07/31/2029

Why are you being asked to complete this form?

We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years.

Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

How do you know if you have a disability?

A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:

  • Alcohol or other substance use disorder (not currently using drugs illegally)
  • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS
  • Blind or low vision
  • Cancer (past or present)
  • Cardiovascular or heart disease
  • Celiac disease
  • Cerebral palsy
  • Deaf or serious difficulty hearing
  • Diabetes
  • Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders
  • Epilepsy or other seizure disorder
  • Gastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndrome
  • Intellectual or developmental disability
  • Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD
  • Missing limbs or partially missing limbs
  • Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports
  • Nervous system condition, for example, migraine headaches, Parkinson’s disease, multiple sclerosis (MS)
  • Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities
  • Partial or complete paralysis (any cause)
  • Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema
  • Short stature (dwarfism)
  • Traumatic brain injury
Select...

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.