Senior Director, Pharmacy & Behavioral Health Program Operations
Hi, we're Oscar. We're hiring a Senior Director, Pharmacy & Behavioral Health to join our Program Operations 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 role
You will be responsible for key delegate vendor partners providing core benefit offerings including Prescription Benefit, Behavioral Health and Transplant driving the strategy, leadership, design, implementation, communication and coordination of a department in deep partnership with stakeholders. You will develop the capabilities and insights to maximize the value of their programs and initiatives through effective relationship and operating models. Ensure that programs are cost-effective and high quality and to oversee these programs to ensure that there are effective controls and monitoring to support Oscar’s strategic and financial objectives.
You will report to the Vice President, Program Operations.
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, California, Colorado, Connecticut, Florida, Georgia, Illinois, 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: $192,000 - $252,000 per year. The base pay for this role in all other locations is: $172,800 - $226,800 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.
Responsibilities
- Design, implement and lead cross-functional strategy for key delegate vendor partners providing core benefit offerings including Prescription Benefit, Behavioral Health and Transplant
- Select and manage strategic vendor partners ensuring that we have a clinically effective and cost-effective program.
- Responsible for the implementation and execution of the pharmacy behavioral health & transplant benefit
- Oversee the Evaluation of opportunities to build internal capabilities vs. outsource to external vendors to select the optimal model for Oscar to pursue
- Drive transformation based on latest trends in the marketplace to activate and scale high potential and impact opportunities
- Enhance the departments overall value by setting and achieving justifiable and scaled goals
- Identify opportunities for efficiency and automation
- Foster widespread engagement – by internal and external stakeholders
- Manage team and external partners to specific and measurable goals in quality and productivity and ensure team is meeting performance targets and regulatory requirements
- Represent Program Ops and works with senior management, executives, vendors and/or major customers/partners which frequently involves negotiating matters of significance to the organization
- Support departmental budgeting process including support business case justification for major investments
- Compliance with all applicable laws and regulations
- Other duties as assigned
Qualifications
- 12+ years program management of strategic partners
- 5+ of experience in healthcare, including roles at consulting firms, PBM, or health plans
- 7+ years leading people and teams
- Experience with Vendor Management on behalf of health plans OR Account Management for a vendor who services health plan
- Knowledge of the PBM industry
Bonus Points
- Health plan experience
- MBA
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 (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 Notice to Job Applicants.
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Hey there! We're Oscar, and we're excited to announce an opening for a Senior Director, Pharmacy & Behavioral Health Program Operations in our Program Operations team. At Oscar, we've built a health insurance company like no other, leveraging a full stack technology platform with the aim of truly serving our members. As our Senior Director, you'll have the opportunity to shape the core benefit offerings including our Prescription Benefit, Behavioral Health, and Transplant programs. Your role will be crucial in developing strategies that align with our stakeholders while maximizing the value and quality of our services. You'll lead a dedicated team focused on ensuring our programs are effective and cost-efficient, all while maintaining compliance with the applicable regulations. Communication is key as you'll be engaging with various teams and partners, fostering collaboration and innovation. If you're passionate about transforming healthcare and you have a strong background in program management, we want to hear from you! Join us in creating an insurance experience that feels personalized, trustworthy, and supportive—like having a doctor in the family. Plus, with our remote-friendly culture, you can work comfortably from home while staying connected to our dynamic team. Connect with us, explore your potential, and help us streamline the health benefits that are vital to our members' lives!
By
Oscar Health
Oscar Health is an American health insurance company headquartered in New York City. Through telemedicine, healthcare-focused technology interfaces, and clear claims pricing systems, the company focuses on the health insurance market.
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