Senior Director, Operational Excellence

About the role

You will be a leader and oversee the architectural integrity and performance of Oscar's core insurance service pillars. Reporting to the SVP, Insurance Operations, you will lead a sophisticated organization through four key pillars covering Managed Services, Workforce Management, Process Optimization, and Quality Management. You will design for a "consultant-operator"-someone who pairs a rigorous management consulting background with deep experience running large-scale shared services in a healthcare environment. You will be the primary architect of Oscar's operational engine, ensuring these four different functions work in lockstep to deliver a tech-enabled, seamless member experience. Your mission is to balance rapid scalability with lean efficiency, ensuring that as Oscar grows, our operational quality and member satisfaction remain industry-leading. You will report into the SVP, Insurance Operations. Work Location: This position is based in our New York City 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: $198,720 - $260,820 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants, and annual performance bonuses.

Responsibilities

• Set the organizational tone, strategy, and tenor for the Operational Excellence organization, fostering a culture of high accountability, empathy, and relentless improvement that aligns with Oscar's mission.
• Provide strategic direction and horizontal oversight for the four primary operational pillars: Managed Services (BPO/Vendor Mgmt), Workforce Management, Operational Excellence (Process/Execution), and Quality Management.
• Directly manage, coach, and enhance a team of leaders of Associate Directors and Directors ensuring cross-functional alignment and breaking down silos between the operational sub-units.
• Optimize the shared services model to support Oscar's diverse lines of business, ensuring that centralized resources are deployed with maximum efficiency and high ROI.
• Synthesize complex operational data into high-level insights for senior leadership. Simultaneously, craft a compelling vision for the broader organization that drives buy-in, alignment, and a shared sense of purpose across all four pillars.
• Apply a management consulting lens to diagnose complex operational friction points within the healthcare payer space, designing end-to-end solutions that improve throughput and member outcomes.
• Leverage deep healthcare experience to ensure all operational workflows meet or exceed stringent regulatory requirements (CMS, NCQA) and internal Total Quality Management (TQM) standards.
• Oversee the strategy for offshore and outsourced partners, ensuring BPO performance is indistinguishable from internal quality and intergrate into Oscar's culture.
• Direct the Workforce Management and Forecasting teams to build high-precision capacity models that account for healthcare seasonality and rapid member growth.
• Champion a culture of data-driven process optimization, utilizing Lean or Six Sigma methodologies to drive down the "cost-to-serve" while improving the "quality-to-member."
• Act as the lead operational stakeholder for Product and Engineering teams, translating operational pain points into technical requirements for internal tool development.
• Manage a significant operational budget and provide the SVP, Insurance Operations with clear, data-backed visibility into the health, scalability, and financial performance of the organization.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements

• 12+ years of healthcare industry experience, with at least 7 years specifically in a Managed Care operations environment.
• 8+ years leading Shared Services functions, with a proven track record across BPO, Workforce Management, and Quality Management.
• 8+ years of strategic leadership, specifically driving cross-functional transformations across Clinical, Product, and Tech/Engineering teams.
• 7+ years of executive vendor management, with demonstrated success scaling and integrating multi-shore BPO partners.
• 5+ years of experience as a "manager of managers," overseeing mid-to-senior level leaders and complex matrixed teams.
• 5+ years of financial accountability, including direct ownership of departmental budgets and high-precision capacity mod

Benefits

Additional Information

Hi, we're Oscar. We're hiring a Senior Director, Operational Excellence to join our Insurance Operations 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.

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