Senior Network Contracting Specialist

Hi, we're Oscar. We're hiring a Senior Network Contracting Specialist to join our Network Contracting.

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:

As a Senior Specialist of Network Contracting you will negotiate and manage contracts with healthcare providers, including hospitals, health systems, and individual providers. These contracts aim to develop a network in assigned markets or regions. Additionally, you will ensure access to quality care and improve costs by analyzing provider performance and negotiating reimbursement rates. This often involves complex contract terms and compliance with regulatory guidelines. You will also help recruit new providers to the network, assisting with resolution of provider issues, and supporting cost-saving projects.

Work Location: This is a remote position based in the field, open to candidates who reside: Arizona, Florida, Illinois, Iowa, Kansas, Michigan, Mississippi, Missouri, New York, Nebraska, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, or Virginia. Your daily work will involve a blend of work from your home office and frequent travel for client meetings. #LI-Remote

Pay Transparency: The base pay for this role $71,539 - $93,895 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

Responsibilities:

• Support and direct involvement with negotiating contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards, strategy, and regulatory requirements.
• Conduct comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization.
• With support from your leader, uses data and analytics of provider financial issues and competitor strategies to inform negotiation and contracting decisions.
• Support implementation of contracting policies and workflows; monitor and ensure effective and efficient contracting processes are in place.
• With input and support from their leader, monitor and analyze important metrics for network performance, cost, and provider satisfaction, and provide reports to leadership for assigned provider accounts.
• Ensure timely and professional resolution of provider issues
• Build relationships with healthcare providers to ensure network stability and quality.
• Help track and analyze goals to monitor provider satisfaction and operational efficiency.
• Support provider onboarding, training, and resource distribution.
• Collaborate with other teams such as Claims, Credentialing, and Contracting to resolve routine provider issues.
• Participate in process improvement projects to improve workflows and enhance provider experience.
• Compliance with all applicable laws and regulations (DO NOT REMOVE - REQUIRED)
• Other duties as assigned (DO NOT REMOVE - REQUIRED)

Requirements:

• 2+ years of experience in provider network operations or contracting or provider services
• 1+ years of experience in Health Insurance (Individual or Medicare Advantage) or Healthcare industry
• 1+ years experience navigating and organizing large datasets such as claim files and provider rosters

Bonus points:

• Associate's degree or equivalent professional working experience.