Medical Director Scientific Affairs

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About the role

Hi, we're Oscar. We're hiring a Medical Director Scientific Affairs to join our Clinical Affairs 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 Medical Director Scientific Affairs provides strategic leadership to the Clinical Policy team, ensuring medical and pharmacy policies are rigorously evidence-based and aligned with current clinical advancements. This role manages the full policy lifecycle, from literature evaluation to final execution. The Medical Director, Scientific Affairs directs Oscar Health's clinical publishing efforts, and serves as a cross-functional scientific authority across the organization. You will report into our Vice President, Clinical Affairs. Work Location: This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $237,719- $312,006 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses. Responsibilities: • Serve as the primary evidence-based subject matter expert, translating clinical research into actionable strategies to elevate care quality across the organization. • Lead the research, development, revision, and clinical accuracy of all medical, utilization management (UM), and pharmacy coverage policies. • Advise executive leadership on emerging medical therapies, complex clinical trends, and population health utilization patterns using data-driven insights. • Support the development of clinical and lifestyle products through the production of evidence based research tailored to target populations. • Foster academic partnerships to advance and publish clinical research leveraging health plan population data. • Lead the systematic review of major specialty society guidelines (e.g., ASCO, ACC, AACE), ensuring policies reflect established standards of care and objective evidence evaluation. • Establish, maintain, and enforce the formal framework for grading clinical evidence, ensuring all medical and pharmacy policies are anchored in high-quality, peer-reviewed literature. • Oversee Clinical Advisory Subcommittees - setting agendas, presenting clinical evidence packages, and driving expert consensus to guide policy decisions. • Partner with Pharmacy Services (P&T Committee), Legal, and Compliance to seamlessly integrate coverage policies that meet or exceed NCQA standards and state/federal mandates. • Support interactions with federal and state regulatory bodies (e.g., FDA, CMS, State DOIs) as needed. • Compliance with all applicable laws and regulations. • Other responsibilities as assigned. Requirements: • 10+ years working in relevant fields. • 6+ years clinical policy experience in health insurance, PBM, or other clinical guideline development organization. • 4+ years experience in clinical policy drafting and development. • 4+ Years of experience leading, chairing, or facilitating multi-disciplinary clinical committees or advisory subcommittees. • 4+ years publishing in relevant fields. • 3+ years of experience communicating with executives and interacting with all levels of the organization. • 3+ years of leadership experience as a people manager. • 1+ years of experience with medical coding t

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