Associate, Network Contracting

Hi, we’re Oscar. We’re hiring a Associate, Network Contracting to join our Specialist Contracting 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:

You will be responsible for managing contracts with key healthcare providers in Oscar’s network (hospital/health systems and large national ancillary groups) to build and maintain a robust network; while also ensuring access to quality care and optimizing costs by analyzing provider performance and negotiating reimbursement rates, often involving complex contract terms and compliance with regulatory guidelines. Supporting cost saving initiatives, executing national network strategy, and ensuring high performing network development and ensuring providers across our service area have the information and support they need to provide best-in-class member care.

You will report into the Senior Director, Speciality Contracting.

Work Location: This is a remote position based in the field, open to candidates who reside: Alabama, Arizona, Florida, Illinois, Iowa, Kansas, Michigan, Mississippi, Missouri, Nebraska, North Carolina, Ohio, Texas. 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 is: $87,560 – $114,434 per year. You are also eligible for employee benefits, monthly vacation accrual at a rate of 15 days per year, participation in Oscar’s unlimited vacation program and annual performance bonuses.

Responsibilities:

• Implement contracting strategies under the direction of Network Director and/or Senior Manager and in partnership with Market Leaders that align with the company’s overall network adequacy, development and cost management objectives.
• Manage and negotiate contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards and regulatory requirements.
• Support comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization.
• Utilize data and analytics of provider financial issues and competitor strategies to support informing negotiation and contracting decisions.
• Meet defined metrics and SLAs including but not limited to provider outreach and contract completion.
• Collaborate with the provider services team regarding the servicing, education and communication to our provider network.
• Monitor assigned networks to gauge compliance with standards, developing corrective action plans with network contracting and market leadership to remediate deficiencies.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• 3+ years of experience in healthcare client management, healthcare consulting, or provider healthcare contracting, healthcare operations, or a related field
• 2+ years of experience supporting provider network strategy development and negotiating provider contracts
• 1+ years experience running financial analyses on a markets or product lines, and working cross-functionally to support driving improvement opportunities
• 1+ years experience navigating and organizing large data sets such as claim files and provider rosters

Bonus points:

• Associate’s degree or equivalent professional working experience.