O

Oscar Health

Tech-driven health insurance with virtual care

Market Medical Officer - Central

Full-TimeUpdated on 10/1/2026
$261.6k - $381.4k/yr+ Equity grants + Annual performance bonus
Expert
Master's, MD
Remote in USA
RemoteRemote work is limited to residents of Illinois, Indiana, Michigan, Ohio, Iowa, Kansas, or Nebraska; occasional travel is required for team meetings and company events.

About the job

Requirements
  • At least 12 years of progressive leadership experience in healthcare.
  • At least 10 years of managed-care experience, including prior leadership in a matrix environment.
  • At least 7 years of clinical leadership experience in the role-specific market.
  • At least 7 years managing clinical market trends in health insurance or full-risk-bearing clinical provider groups.
  • At least 5 years of clinical practice and board certification in internal medicine, family medicine, general surgery, emergency medicine, or another considered field.
  • At least 5 years of experience leading teams.
  • An MD or DO and a current unrestricted license to practice medicine in a state in the region: Illinois, Indiana, Michigan, Ohio, Iowa, Kansas, or Nebraska.
  • Reviewers must maintain necessary credentials, including active board certification.
  • Willingness and ability to obtain additional state licensure, with Oscar's support.
Responsibilities
  • Drive performance of regional plans' clinical metrics for trend management and market performance in partnership with market P&L leadership, including ED/K, APK, ALOS, and other metrics.
  • Partner with Medical Economics to identify market-based utilization trends and flares, then develop solutions addressing key drivers to reduce overall spend.
  • Build strategic partnerships with health systems, physician groups, and community providers to align incentives and lower the total cost of care.
  • Serve as the regional clinical partner across internal teams, partnering closely with Affordability, Utilization Management, Care Management, Claims, and others to drive regional performance goals.
  • Partner with Network Contracting leadership to guide clinical initiatives that enhance provider alignment, care quality, and clinical outcomes across the region.
  • Proactively identify and resolve regional network gaps and access barriers to advance equitable, high-quality care across member populations.
  • Collaborate with regulatory agencies and compliance teams to ensure regional network adequacy and quality programs comply with state and federal requirements, translating policy changes into proactive operational strategy that protects member access and organizational performance.
  • Serve as the point of accountability for regional escalations, including internal and external appeals, provider and member grievances, and complex case management scenarios.
  • Comply with all applicable laws and regulations.
  • Perform other responsibilities as assigned.
Desired Qualifications
  • P&L experience for a risk-bearing entity.
  • Licensure in multiple Oscar states.
  • A master's degree or advanced certificate.
  • Prior experience with Utilization Management.

About the company

Oscar Health is a U.S. health insurer that uses technology to simplify health care for individuals, families, and small businesses, offering ACA-compliant and other plans. Its products run on a digital platform with 24/7 virtual care and tools to find in-network doctors, hospitals, and pharmacies, plus cost-management features. It differentiates itself with a tech-driven member experience, high accessibility, round-the-clock telemedicine, and clear access to in-network providers. The goal is to make healthcare simple, accessible, and affordable in the United States by streamlining enrollment, care access, and costs.

Company Size

1,001-5,000

Company Stage

IPO

Headquarters

New York City, New York

Founded

2012

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Simplify's Take

What believers are saying

  • Q2 2026 revenue hit $4.88 billion, up 70%, and operating income reached $388.6 million.
  • Oscar raised 2026 operating guidance to $500 million-$700 million after first-half net income of $1.04 billion.
  • Management says Oswell and AI claims processing drive lower costs, with 98.7% first-pass accuracy.

What critics are saying

  • CMS eligibility reviews threaten 250,000-300,000 retroactive disenrollments, hitting Oscar’s 2026 membership base.
  • A Southern District of New York data-breach class action began June 2026 after delayed notice.
  • House Republicans subpoenaed Oscar on February 9, 2026, escalating ACA fraud scrutiny.

What makes Oscar Health unique

  • Oscar’s full-stack ACA platform and AI tooling cut SG&A to 15.6%-16.1% in 2026.
  • ICHRAx, launched August 2026, stitches competitors into Oscar’s employer-conversion enrollment rails.
  • Oscar’s member growth reached 2.96 million by June 30, 2026, validating distribution.

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Benefits

Health insurance - That’s a given. Employees and their families receive incredible health insurance.

Financial benefits - A penny saved....we’re talking about a 401K plan, health savings accounts, and more.

Well @ Oscar - We care about your wellness with fitness classes and access to mental health support.

Work-Life Balance - We offer multiple time-off options, wellness days, and 10+ weeks of parental leave.

Learning & Development - We offer everything from mentorship to management training.

Growth & Insights and Company News

Headcount

6 month growth

↓ -1%

1 year growth

↓ -2%

2 year growth

↓ -1%
Yahoo Finance
Sep 24th, 2026
Oscar Health posts profit after 3 quarters of losses, but faces medical cost pressures in H2 2026

Oscar Health has returned to profitability after three consecutive quarterly losses, posting operating profits in both the first and second quarters of 2026. Membership reached 2.96 million as of 30 June, up from 2.03 million a year earlier. Second-quarter revenues climbed 70% to $4.88 billion, whilst the medical loss ratio improved to 79.2% from 91.1%. Oscar generated $388.6 million in operating earnings, contrasting with a $230.5 million operating loss a year ago. Oscar raised its 2026 operating earnings outlook to $600 million-$800 million and lowered its expected medical loss ratio to 81%-82%. The company earned $1.09 billion from operations in the first half, meaning its updated guidance implies a second-half operating loss of roughly $293 million-$493 million.

Yahoo Finance
Sep 12th, 2026
Oscar Health stock targets $32 as USANA and Oceaneering face headwinds

Oscar Health, a technology-focused health insurance company, is highlighted as a potential investment opportunity. Founded in 2012, the company offers individual and small group health plans through its cloud-native platform, aiming to simplify the American healthcare system. Its shares currently trade at $32.10. Two stocks are recommended to avoid. USANA Health Sciences, a direct-selling manufacturer of nutritional and personal care products, has seen revenue decline by 1.2% annually over the past three years. Oceaneering International, which provides remotely operated underwater vehicles for offshore energy exploration, has posted modest 9.8% annual revenue growth over five years with weak margins.

MedCity News
Sep 1st, 2026
Healthcare moves: A monthly summary of hires, exits and layoffs.

Healthcare moves: A monthly summary of hires, exits and layoffs. August has seen a slew of executive hires, exits and layoffs across the healthcare industry. For instance, Humana, Merck and Mayo Clinic named new executives. There were also layoffs at organizations including MaineHealth, Cellares and Sharp HealthCare. By Katie Adams on August 31, 2026 8:17 pm This roundup is published monthly. It is meant to highlight some of healthcare's recent hiring news and is not intended to be comprehensive. If you have news about an executive appointment, resignation or layoff that you would like to share for this roundup, please reach out to [email protected]. Hires and promotions Adonis, an AI startup tackling hospitals' denied and underpaid claims, hired Alison Bloom-Kiefer as its chief product officer and promoted Doug Pickett to chief revenue officer. Bloom-Kiefer comes to the organization from Oscar Health, where she served as vice president of provider experience strategy and innovation. Pickett joined Adonis in 2023 as director of strategic sales. Before that, he worked at Cedar as vice president of commercial strategy. presented by In an interview, Kyan Health Co-Founder and Chief Commercial Officer Konstantin Struck discussed how Kyan gives mid-market and enterprise employers access to premium workforce mental healthcare, at a price point that is affordable. North Carolina-based Cone Health named Ryan Christensen as chief value-based care officer. He comes to the organization from Intermountain Health, where he worked as enterprise vice president of operations for proactive care services. Humana welcomed J.P Holland as its new Medicaid president. He joins the organization from Johns Hopkins Health Plans, where he served as CEO. Prior to that, he was the CEO of Elevance Health's Alliance Business. Mayo Clinic appointed Arun Kumar Bhaskara-Baba as its new CIO. He comes to the health system from Honeywell Aerospace and Defense, where he held the same title. Bart Gourley joined Merck as the pharma giant's chief AI officer. In the past, he has held leadership roles at EY, Amazon and Accenture. presented by What if health plans could identify member decline before an avoidable hospitalization occurs? Real-time clinical visibility into long-stay SNF members uncovers risk earlier and drives better outcomes. Providence named Kevin Smith as its new CFO. He will join the organization in October after he departs his role as CFO of SSM Health. Care navigation company Quantum Health hired Jamie Hall as its chief commercial officer and Daniel Stein as its chief strategy officer. Hall joins Quantum through the company's acquisition of CirrusMD, and Stein joins through Quantum's purchase of Embold Health. Centene CFO Drew Asher is retiring at the end of the year. He has been in the role since 2021. Two of Tuft Medicine's top leaders - CEO Mike Dandorph and CFO Andrew Devoe - announced they're stepping down from their roles as the health system begins a major financial turnaround effort. Cell therapy manufacturing specialist Cellares plans to lay off about 100 employees after Bristol Myers Squibb terminated its manufacturing partnership, ending Cellares' role in producing the CAR-T therapy Breyanzi. The impacted workers are primarily software engineers, quality control and design staff, and manufacturing specialists. MaineHealth is cutting 83 positions in its information technology and analytics departments, consolidating three teams into one as part of a larger redesign. The reorganization eliminates 56 IT roles and 27 of the system's 63 analytics positions. Sharp HealthCare announced an organizational realignment affecting 260 employees, marking its second layoff wave in just over a year following last summer's elimination of 315 roles. The San Diego-based health system, which reported an operating loss of $173.5 million despite $5.5 billion in revenue, pointed to rising costs and federal and state policy changes as factors. Many of the affected workers were immediately offered alternative positions within the system.

Yahoo Finance
Aug 15th, 2026
Oscar Health beats Q2 estimates with $4.88B revenue and $1.10 adjusted EPS amid membership surge

Oscar Health reported second-quarter results that exceeded Wall Street expectations, though the market reacted negatively. Revenue reached $4.88 billion, beating estimates of $4.74 billion and marking 70.4% year-over-year growth. Adjusted earnings per share came in at $1.10, significantly above the $0.38 estimate. CEO Mark Bertolini attributed the performance to disciplined pricing, technology-driven efficiencies, and strong execution in individual health insurance. Membership increased 46% year-over-year, whilst administrative cost ratios hit historic lows. Operating margin improved to 8%, up from negative 8% in the same quarter last year. Adjusted EBITDA of $415.3 million substantially exceeded the $170.9 million estimate. During the earnings call, analysts questioned management on outpatient utilisation trends, medical loss ratio guidance, and the potential impact of CMS eligibility reviews on member retention.

Yahoo Finance
Aug 12th, 2026
Oscar Health gains Wall Street support despite 1% price target as analysts turn bearish on Envista and OneMain

Wall Street analysts have issued bearish price targets for several stocks, signalling serious concerns about their prospects. StockStory conducted independent analysis to identify buying opportunities and companies to avoid. The firm recommends avoiding Envista Holdings, a global dental products company. Its revenue grew just 3.4% annually over five years, whilst earnings per share fell 7% annually. Negative returns on capital suggest growth strategies have backfired. StockStory also advises caution on OneMain Holdings, which provides personal loans to nonprime consumers. Despite 5.5% annual revenue growth over five years, earnings per share declined 9.3% annually. The firm identifies Oscar Health, a technology-focused health insurance company founded in 2012, as a potential buying opportunity despite Wall Street's pessimism.