Managed Care Coordinator Jobs in Arizona

Hi, we're Oscar. We're hiring a Director, Managed Business Services to join our 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

You will be the primary architect of our global outsourcing strategy and be responsible for the end-to-end health of our outsourced ecosystems. This service covers multiple contact center, business process and configuration functions and works with multiple vendors across several countries. This strategic leadership role designs, implements, and governs external operations to ensure they align with company quality and compliance standards, cost objectives, and customer experience goals. You will report into the SVP, Insurance Operations.

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.

Pay Transparency:

The base pay for this role is: $147,549 - $193,658 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 the ongoing analysis and cross-functional framework to determine which business functions are optimized for outsourcing versus internal retention.
- Design and execute an operating model that supports scalability, ongoing risk mitigation, and the execution of critical business initiatives across a matrixed organization.
- Drive core business transformation by identifying emerging marketplace trends and shifting the outsourcing model from transactional tasks to transformational outcomes.
- Align service provider visions with long-term corporate goals to ensure flexibility and growth as market demands change.
- Drive the end to end selection process, in partnership with Procurement and operational leaders, including RFP leadership, vendor vetting, and onboarding of partners that align with company scale and culture.
- Partner closely with Procurement to identify and execute optimal Master Service Agreements (MSAs) and Statements of Work (SOWs) while monitoring value delivery and ROI.
- Negotiate matters of significance with senior management and external executives to ensure favorable commercial terms and operationally effective programs.
- Ensure the establishment and monitoring of rigorous Service Level Agreements (SLAs) and Key Performance Indicators (KPIs) focused on financial accuracy, productivity, and member experience.
- Perform ongoing operational governance by preparing consolidated performance reports that provide actionable insights and root-cause identification for issues.
- In partnership with finance, track ROI on outsourcing initiatives. Ensure meticulous billing analysis and the identification of opportunities for long-term cost savings.
- Set and enforce rigorous standards for all offshore and nearshore sites to ensure total adherence to HIPAA, CMS regulations, SOC2, and data privacy requirements.
- Partner with internal Audit, Security, and Compliance departments to lead the operational response to any vendor-side audits or data incidents.
- Lead the transition and change management of new work streams, including the creation of documentation, training protocols, and workflow design.
- Act as the primary bridge between internal departments and external partners to ensure seamless knowledge transfer and brand consistency.
- Create an attractive value proposition for vendor staff to minimize turnover, preserve institutional knowledge, and ensure external teams are educated on company priorities.

Requirements

- Bachelor's Degree in Business, Operations or relevant field
- 10+ years in Insurance Operations
- 8+ years working with teams in multiple locations and within multiple disciplines
- 8+ years of coaching and developing leading cross-functional people and teams
- 6+ years of experience in LEAN, Six Sigma, or other improvement methodologies
- 6+ years of experience leading large-scale implementations or expansion implementations across multiple site locations or business units
- 5+ years of experience in procurement processes, including negotiating and contracting BPO services
- 5+ years managing 3rd-party BPO/ITO relationships for major functions in insurance operations.
- Strong legal and commercial acumen with experience in multi-million dollar contract negotiations.
- Ability to influence internal/external and onshore/offshore leadership

Bonus Points

- MBA or relevant advanced degree
- 10+ years of experience on Insurance Payer side
- Advanced experience with Procurement or Contract Management functions
- Advanced experience in healthcare
- Experience managing international teams across different time zones (APAC, LATAM, EMEA).
- Proven track record of scaling an outsourcing program from "scratch" to a global footprint.

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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.

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