[Hiring] Director, Pharmacy Operations Strategy & Integration @Oscar Health

Role Description

The Director, Pharmacy Operations Strategy & Integration reports to the SVP, Pharmacy and is responsible for shaping and executing Oscar's pharmacy operational excellence agenda for the Pharmacy Clinical Strategy and Operations area. This role translates strategic priorities into a coherent portfolio of operating-model improvements, cross-functional programs, vendor capabilities, and scalable workflows that advance affordability, health outcomes, and the member and provider experience.

• Set the pharmacy operational excellence strategy, operating rhythm, and execution model.
• Lead high-priority pharmacy operational transformation initiatives from strategy through execution.
• Serve as a primary operational partner across internal and external teams.
• Stay aware of applicable PBM, pharmacy benefit, managed care, and healthcare regulatory requirements.
• Maintain deep understanding of the pharmacy and healthcare ecosystem.
• Partner with cross-functional internal stakeholders and external vendors to manage implementation plans.
• Coordinate cross-functionally across various departments to align decision rights and delivery plans.
• Serve as an internal consultant to diagnose complex process, data, technology, and vendor friction points.
• Shape the end-to-end member and provider experience by identifying friction points and translating insights into improvements.
• Lead governance and executive reporting for pharmacy operational excellence initiatives.
• Identify and manage implementation risks, dependencies, decisions, and change-management needs.
• Build repeatable operating playbooks, process standards, controls, and best practices.
• Use independent judgment to resolve complex problems and determine the best course of action.
• Support capacity planning, budget management, business-case development, and value realization measurement.
• Ensure operational workflows, vendor capabilities, and program execution meet applicable regulatory requirements.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Qualifications

• 10+ years of experience in healthcare, business operations, strategy and operations, product operations, or program leadership.
• 7+ years of Managed Care, PBM, pharmacy operations, clinical operations, or related healthcare payer experience.
• 5+ years leading large-scale, cross-functional strategy, operational transformation, or implementation initiatives.
• 5+ years partnering directly with cross-functional business, Product, Engineering, vendor, or operations teams.
• Experience interpreting regulatory, compliance, operational, or contractual business needs.
• Experience with strategic planning, roadmapping, business analysis, operational readiness, and change management.
• Experience translating complex operational data and performance information into executive-level insights.
• Experience managing budgets, capacity models, business cases, or financial performance for operational initiatives.

Requirements

• MBA, MPH, Master's degree in Business Administration or a related field preferred.
• Management consulting, internal strategy and operations, process engineering, Lean, Six Sigma experience.
• Experience with PBM implementation, pharmacy benefit administration, claims adjudication, formulary operations.
• Experience working in matrixed teams through enterprise transformation, implementation, or operational excellence work.

Benefits

• Employee benefits including medical, dental, and vision benefits.
• 11 paid holidays.
• Paid sick time.
• Paid parental leave.
• 401(k) plan participation.
• Life and disability insurance.
• Paid wellness time and reimbursements.