Senior Specialist, Network 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 Senior Specialist, Network Contracting is responsible for negotiating and managing Single Case Agreements (SCAs) with healthcare providers (hospital/health system and individual) to build and maintain a robust network in an assigned market/region. This role ensures access to quality care and optimizes costs by analyzing provider performance and negotiating reimbursement rates, often involving complex contract terms and compliance with regulatory guidelines. The Senior Specialist also plays a role in recruiting new providers to the network, assisting with resolution of provider issues, and supporting cost-saving initiatives. You will report into the Director, Network Contracting.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.

Responsibilities

• Support and direct involvement with negotiating contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards, strategy, and regulatory requirements.
• 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, with support from your leader.
• Support implementation of contracting policies and workflows; monitor and 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 for assigned provider accounts, with input and support from your leader.
• Ensure timely and professional resolution of provider issues.
• Build and maintain positive relationships with healthcare providers to ensure network stability and quality.
• Assist in tracking and analyzing key performance indicators (KPIs) to monitor provider satisfaction and operational efficiency.
• Support provider onboarding, training, and resource distribution.
• Collaborate with internal teams such as Claims, Credentialing, and Contracting to resolve routine provider issues.
• Participate in process improvement initiatives to optimize workflows and enhance provider experience.
• Ensure compliance with all applicable laws and regulations.
• Other duties as assigned.

Requirements

• 2+ years of experience in provider network operations or contracting or provider services.
• 1+ years of experience in Health Insurance (Individual and/or Medicare Advantage) and/or Healthcare industry.
• 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

The base pay for this role is: $71,539 - $93,895 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

Benefits

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.
• Paid wellness time and reimbursements.