Manager, National Provider 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 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

The Manager of National Network Contracting is responsible for leading a team of direct 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. This role manages an assigned portfolio of large national ancillary providers and/or multi-state health systems across the contracting lifecycle—from market assessment and recruitment through negotiation, implementation, performance management, renewal, and escalation. Working with Network leadership and cross-functional partners, this role translates network access and affordability goals into executable contract strategies; uses financial, claims, and provider data to inform negotiations; and maintains durable provider relationships.

You will report into the Senior Director, Specialty Contracting.

This is a remote position based in the field, open to candidates who reside in: Alabama, Arizona, California, Florida, Illinois, Iowa, Kansas, Michigan, Mississippi, Missouri, Nebraska, New York, North Carolina, Ohio, and Texas. 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.

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.
• Oversee a small team of contracting 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.
• Conduct 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 inform negotiation and contracting decisions and to support the team in doing so.
• Key player in implementation of contracting policies and workflows; monitor and ensure effective and efficient contracting processes are in place.
• Monitor key metrics for network performance, cost, and provider satisfaction, and provide reports to leadership for assigned accounts.
• Ensure you and your team are providing 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

• 4+ years in healthcare network contracting, including executing contracts with health systems, hospitals or national providers, provider relations, or network management.
• 2+ years of experience managing complex Provider Network strategies and negotiating complex contracts.
• 2+ years of people management experience.
• 2+ years experience in Health Insurance (Individual and/or Medicare Advantage) and/or Healthcare industry.

Bonus Points: Bachelor's degree or equivalent professional working experience.

Pay

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $111,780 - $146,711 per year. The base pay for this role in all other locations is: $100,602 - $132,040 per year. You are also eligible for employee benefits, 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.