Senior Network Specialist

Summary

Join Oscar's Network Contracting team as a Senior Network Specialist! Negotiate and manage contracts with healthcare providers to build and maintain a robust network. Analyze provider performance, negotiate reimbursement rates, and ensure access to quality care. Recruit new providers, resolve provider issues, and support cost-saving initiatives. This remote position requires 25% travel and residency in Arizona, Illinois, or Iowa. The base pay is $69,120.00 - $90,720.00 per year, plus benefits and bonuses. You will report to the Manager, Network Contracting.

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 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
• 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