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Medical Director
Behavioral Health
Posted on 11/30/2022
INACTIVE
Locations
Remote
Experience Level
Entry
Junior
Mid
Senior
Expert
Desired Skills
Management
Communications
Requirements
  • MD or DO with a current unrestricted license to practice medicine in the US. You should be willing to obtain additional state licenses, with Oscar's support
  • Board certified in psychiatry
  • 3+ years of clinical practice as a psychiatrist
Responsibilities
  • Participate in the implementation, supervision, evaluation, and oversight of the behavioral health aspects of Oscar's utilization management program
  • Develop a working relationship with important regulators and accrediting bodies, and represent Oscar externally in behavioral health clinical matters and audits where applicable
  • Provide clinical determinations based on evidence-based criteria and Oscar internal policies, while using your clinical knowledge
  • Clearly document all communication and decision-making in Oscar workflow tools, ensuring a member could easily reference and understand your decision
  • Meet the appropriate turn-around times for clinical reviews
  • Review escalated reviews (either initial denial or internal / first level appeal)
  • Conduct peer-to-peer discussions with treating providers to clarify clinical information and explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research
  • Maintain oversight for quality improvement and medical management services on behavioral health at Oscar, including participation in relevant committees and sub-committees of the Quality Improvement (QI) program
  • Support oversight of behavioral health vendors, including quality assurance of delegated functions, when applicable
Desired Qualifications
  • 1+ years of behavioral health managed care, utilization review or equivalent experience
  • Licensure in multiple Oscar states (AZ and CA preferred)
  • Experience with behavioral health care management
  • Experience in a startup: understanding the pace and culture
Oscar Health

1,001-5,000 employees

Health insurance company
Company Overview
Oscar Health’s mission is to make high-quality health insurance accessible and affordable for everyone. The company is a software driven health insurance company that offers medical plans, medicare advantages, and small group products.
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.
Company Core Values
  • What we do is a big deal. We’re solving problems that change and save lives.
  • Powered by people. Members above all. Developing and growing others is what raises the bar.
  • No genius without grit. Be relentless. Be scrappy. Trying and failing beats not trying and changing nothing.
  • Seek the truth... but never assume you’ve found it. Be scientific.
  • Inspire & provoke. Develop and display leadership at all levels. Fight to be the best.
  • Be transparent. Give and ask for direct feedback. Be grateful for and excited by the help of others.
  • Make it right. Admit your mistakes. Then learn from them. Never build alone.