Behavioral Health Regional Medical Director - CA
- Los Angeles, CA
At Oscar, we work hard to provide the kind of health insurance we would want for ourselves. This means that we get to be creative and to build an excellent health insurer from the ground up. We’ve brought together leaders from top technology and healthcare companies to create a talented team, all of whom are passionate about using technology, data, and design to deliver a better healthcare experience.
We're looking for an experienced physician to provide clinical leadership as a Regional Medical Director to support our continued expansion. As an Oscar Regional Medical Director, you will have oversight responsibility for the medical management, quality improvement and clinical regulatory programs in your region. You will also have the opportunity to utilize your behavioral health expertise to define and drive Oscar’s future behavioral health strategy. This is a full-time role. Although the location of the role can be flexible, you should reside in an existing Oscar market. The role reports to Oscar's Senior. Medical Director.
More specifically, success in this role will require you to:
- 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.
- 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.
Required experience and qualifications include:
- 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
- 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
- Professional skills / attributes:
- Influencer - able to move people without formal reporting structure
- Excellent communication - written and spoken
- Comfortable working with and speaking about technology
- A passion for healthcare transformation that generates excitement with regulators and partners
- Understanding of managed care regulatory structure and processes
- Detail-oriented, flexible, and able to work autonomously with little supervision
Bonus points if you have:
- 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
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we work to cultivate an environment where exceptional people can be their most authentic selves and find both belonging and support. We're on a mission to change healthcare -- an experience made whole by your unique background and perspectives.
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 (email@example.com) to make the need for an accommodation known.
Pay Transparency Policy
Oscar ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.
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