Manager, Network Contracting & Services

Hi, we're Oscar. We're hiring a Manager, Network Contracting & Services to join our Northeast Network 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 leading a team of direct and indirect reports focused on negotiating, executing, and analyzing contracts with large, national and/or complex healthcare group/system providers, focusing on maintaining and enhancing the provider network while meeting accessibility, quality, and financial goals. You will handle dispute resolution and settlement negotiations, ensuring compliance with company standards and regulatory requirements. You will leverage extensive negotiation skills and working knowledge of provider financial issues to optimize contracts, and collaborates with providers, hospitals and health systems to achieve successful contracting outcomes, all while supporting cost-saving initiatives and the growth of the provider network for a defined market or region.

You will report into the Director, Northeast Network.

Work Location: This is a remote position based in the field, open to candidates who reside in: Ohio, Michigan, or Pennsylvania. Your daily work will involve a blend of work from your home office and frequent local travel for client meetings. Occasional travel may be required for team meetings and company events. #LI-Remote

Travel Expectation: 15%

Pay Transparency: The base pay for this role is: $100,060 - $132,040 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

Responsibilities:

• Help inform and drive Implementation of contracting strategies in partnership with Market Leaders that align with the company's overall network adequacy, development and cost management objectives.
• Lead contract settlement negotiations, striving to reach mutually beneficial agreements with providers that maintain and enhance the provider network.
• Manage and negotiate complex contracts with healthcare providers, focusing on favorable terms and compliance with organizational standards and regulatory requirements.
• Work cross-functionally with a team of contracting managers, associates and specialists facilitating leadership, guidance, and mentorship by setting strategic objectives, monitoring team performance, providing training and development opportunities, and fostering a collaborative and innovative work environment.
• Conducts comprehensive reviews and analyses of provider contracts, identifying and surfacing areas for improvement and optimization to appropriate stakeholders
• Utilize working knowledge of provider financial issues and competitor strategies to inform negotiation and contracting decisions.
• Drive Implementation across the contracting team of contracting policies and workflows; ensure effective and efficient contracting processes are in place.
• Monitor and analyze key metrics for network performance, cost, and provider satisfaction, and provide reports to leadership.
• Ensure you and your team provide timely resolution of provider issues related to contract terms, reimbursement, and network participation.
• Build and maintain positive relationships with healthcare providers to ensure network stability and quality.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• 6+ years in healthcare network contracting, including executing contracts with health systems, hospitals or national providers, provider relations, or network management
• 4+ years of experience managing complex Provider Network strategies and negotiating complex contracts
• 3+ years experience in Health Insurance (Individual and/or ACA Market Place) and/or Healthcare industry

Bonus points:

• Bachelor's degree or equivalent professional working experience.
• 3+ years of leadership experience

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. 

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency:  Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.