Associate, Network Contracting & Services (Florida)

About the role

The Associate, Network Contracting & Services is responsible for managing contracts with key healthcare providers in Oscar’s network (hospital/health systems and individual provider groups) to build and maintain a robust network in assigned market/region; 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. The Associate also supports network growth and recruiting efforts by engaging with prospective providers directly; assisting with resolution of provider issues; supporting cost-saving initiatives; executing the local network strategy; and ensuring providers across our service area have the information and support they need to provide best-in-class member care.

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.
• Supports comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization.
• Utilizes data and analytics of provider financial issues and competitor strategies to support informing negotiation and contracting decisions.
• Maintain defined metrics and Service Level Agreements (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.

Pay, Benefits & Schedule

The base pay for this role is: $87,188 - $114,434 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

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.