Senior Network Specialist

Summary

Join Oscar Health as a Senior Network Specialist 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 and reimbursement rates, often involving complex contract terms and regulatory compliance. Recruit new providers, resolve provider issues, and support cost-saving initiatives. This remote position requires residency in Tennessee or Georgia. The base pay is $69,120.00-$90,720.00 per year, plus benefits and an annual performance bonus.

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

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
• Conducts comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization
• With support from your leader, utilizes data and analytics of provider financial issues and competitor strategies to inform negotiation and contracting decisions
• Supports implementation of contracting policies and workflows; monitors and ensures effective and efficient contracting processes are in place
• With input and support from their leader, monitor and analyze key metrics for network performance, cost, and provider satisfaction, and provide reports to leadership for assigned provider accounts
• Ensure and professional resolution of provider issues And build relationships with healthcare providers to ensure network stability and quality
• Help track and analyze measurements 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 programs to increase workflows and enhance provider experience
• Compliance with all applicable laws and regulations
• Other responsibilities as assigned
• Up to 20% travel required

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