Associate, Network Contracting
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.
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.
- Maintain and 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.
- Comply 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.
Work Location
This is a remote position, open to candidates who reside in: Dallas, Texas. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area.
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.
Benefits
- Medical, dental, and vision benefits.
- 11 paid holidays.
- Paid sick time.
- Paid parental leave.
- 401(k) plan participation.
- Life and disability insurance.
- Paid wellness time and reimbursements.