Regional Medical Director

Overview

Responsibilities: Corporate leadership: Provide clinical leadership for behavioral health strategic initiatives and care management. Develop innovative models, including payment models, integrated care models, and virtual care models, to support Oscar’s behavioral health strategy. Support Oscar’s expansion efforts by obtaining necessary licensure and serving as a clinical representative with regulators. Demonstrate the highest level of professionalism, accountability, and service in your interactions with Oscar teammates, providers, and members. Work with fellow regional medical directors, corporate leaders and the Chief Clinical Officer in setting the strategic medical management agenda. Become a source of inspiration and subject matter expert for the build-out of technology and data tools. Locoregional leadership: Establish yourself as the local clinical representative for internal stakeholders and liaison to external parties such as Oscar’s provider partners and clinical vendors. Develop a strong working relationship with regulators in the state, including the Office of Insurance, and represent Oscar in clinical matters and audits. Establish oversight responsibility for clinical functions in your region, including medical management and quality improvement, and interact cross functionally with both clinical and non-clinical counterparts to support their success. Track and analyze key utilization and clinical performance metrics in your region, including identifying and presenting trends to internal and external meetings and committees. Serve as the internal and external point of accountability for escalated clinical issues in your region, including external utilization management appeals, member complaints and grievances and complex case management escalations. Develop familiarity with applicable regulatory and accreditation requirements as well as Oscar tools, teams and workflows in place to ensure we meet them. Qualifications: Licensure: - MD or DO with a current unrestricted license to practice medicine in the US and specifically in California. - Licensure in multiple Oscar states (dependent on region) preferred but not required; you should be willing to obtain additional state licenses, with Oscar's support. - Board certified or eligible in psychiatry Experience: - 3+ years in clinical practice - 3+ years experience in the managed care industry or a provider system - Experience with presentations to regulators, provider systems, accreditation organizations and / or executive leadership Bonus points if the candidate has: - Experience with behavioral health integration - An advanced degree or certificate in business, or equivalent experience - Experience in a startup: understanding the pace and culture - Experience leading business units / clinical teams

Benefits

Company

Healthcare is broken; we're trying to fix it. Our team is focused on utilizing technology, design and data to humanize healthcare. We're a group of technology and healthcare professionals who looked at the current state of the US healthcare 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 healthcare.