Senior Director, Escalated Provider Issue ResolutionActive$197K–$258K
The opportunity
Hi, we're Oscar. We're hiring a Senior Director, Escalated Provider Issue Resolution to join our Network & Provider Management team.
What you'll do
Lead and develop a multi-disciplinary provider issue resolution organization,: including teams focused on strategic provider support, complex issue resolution, root-cause remediation, and provider service governance.
Build a scalable operating model for escalated provider issues, including: intake standards, triage criteria, escalation pathways, ownership expectations, service metrics, and closure practices.
Oversee resolution of high-impact provider issues that require coordination across multiple operational teams.
Partner with leaders across Claims, Network, Utilization Management, Payment: Integrity, Contact Center, Account Management, Technology, and Analytics to improve handoffs, reduce avoidable escalations, and address recurring root causes.
Oversee root-cause remediation by analyzing escalated issue trends,: prioritizing fixes based on provider impact and enterprise ROI, and driving cross-functional follow-through on the highest-value operational improvements.
Establish closed-loop tracking to ensure identified root causes are: addressed, operational fixes are adopted, and improvements reduce recurring provider friction across strategic accounts and the broader provider network.
What they're looking for
- Create executive-ready reporting on provider issue trends, operational: health, risks, blockers, and decisions needed.
- Serve as a senior escalation leader for urgent, complex, or high-profile provider issues.
- Compliance with all applicable laws and regulations
- Other duties as assigned
