Associate, Network Contracting

Summary

Join Oscar's Network Contracting team as an Associate and contribute to building and maintaining a robust healthcare provider network. Negotiate and manage contracts with healthcare providers, ensuring access to quality care and cost optimization. Analyze provider performance, negotiate reimbursement rates, and support network growth initiatives. Engage with prospective providers, resolve provider issues, and assist in implementing local network strategies. This role requires collaboration with various teams and adherence to regulatory guidelines. The position offers a blended work culture with remote options and a competitive compensation package.

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

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
• Serve as a Subject Matter Expert to a small team of contracting specialists and/or analysts, providing guidance and fostering a collaborative and innovative work environment
• 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
• Facilitates guidance and mentorship of more junior team members by reiterating strategic objectives, providing training and development opportunities, and fostering a collaborative and innovative work environment
• Supports implementation of contracting policies and workflows; supports identifying when effective and efficient contracting processes need improvement 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
• Compliance with all applicable laws and regulations
• Other duties as assigned

Preferred Qualifications

Associate’s degree or equivalent professional working experience

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