# Associate Director, Appeals & Grievances at Oscar AI

- Company: Oscar AI
- What the company does: Oscar is an AI operations analyst that watches every location 24/7, catching revenue leaks, labor inefficiencies, and compliance risks, then delivering the alerts, reports, and action plans your team needs to fix them fast. Backed by Techstars.
- Company website: https://oscar.ai
- Type: Startups (AI role)
- Level: Principal and up
- Location: Remote
- Work setup: Remote
- Posted: 2026-09-25
- Apply by: 2026-11-09
- Apply: https://job-boards.greenhouse.io/oscar/jobs/8227025
- Page: https://www.1752.vc/careers/jobs/oscar-ai-associate-director-appeals-and-grievances/

## 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.

## What they're looking for

- 7+ years of progressive experience in healthcare operations, specifically focusing on healthcare compliance, complaints, grievances, or appeals (A&G)
- 4+ years of people management experience, including leading and developing other supervisors, team leads, or managers in a high-volume operations environment
- Advanced knowledge and equivalent experience with Commercial Insurance, Medicare/Medicaid, and Affordable Care Act (ACA) rules and regulations relating to administrative Grievance & Appeals processes
- Experience leading or representing operational teams during CMS, state-level, or other regulatory audits
- Experience using operational data to lead decision-making, manage capacity, and implement process improvements

Tags: Member Care & Services