Associate Director, Appeals & Grievances

Hi, we're Oscar. We're hiring an Associate Director, Appeals & Grievances 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:

The Associate Director, Escalations — Administrative Complaints, Grievances & Appeals (CGA) provides strategic leadership and operational oversight for Oscar's non-clinical Administrative CGA and Elite Member Champion Team (MCT) operations. This role is responsible for driving operational excellence and regulatory compliance across all lines of business, and utilizes Lean methodologies and capacity-based staffing models to maintain strict adherence to federal (CMS) and state turnaround times. The Associate Director, Escalations — Administrative CGA will lead high-performing teams through complex administrative member and provider issue resolutions, leverage case data to mitigate reputational risk, and collaborate with cross-functional partners in Claims, Network, Legal, and Compliance to eliminate root causes and proactively reduce overall escalation volume while fostering a strong talent pipeline.

You will report into the Senior Director Member &am