Oscar is hiring a
SVP, Network and Provider Management

Summary

Join Oscar's Insurance team as a Senior Vice President, Network & Provider Manager. This role is responsible for crafting the overall network strategy, analyzing network adequacy and performance, and ensuring compliance with regulatory requirements.

Requirements

• 20+ years experience in provider contracting, network management, or a related field within the healthcare or health insurance industry
• 10+ years experience leading in matrixed organizations
• 10+ years experience building systems and processes to support provider network operations, from the ground up

Responsibilities

• Support Market leaders with network tooling, adequacy standards and contracting strategies
• Develop long-term strategies for network growth and optimization, addressing gaps in service coverage, and ensuring that the network adapts to changing healthcare trends and member needs
• Utilize market trends and data to inform network strategy and identify opportunities for growth and improvement
• Ensure the development and maintenance of a comprehensive provider network, including hospitals, physicians, and ancillary providers
• Demonstrating shared leadership in the overall insurance business by balancing the need to provide a broad network of services with controlling costs for both the company and policyholders through strong unit cost guidelines and contracting parameters
• Monitor network adequacy and compliance with regulatory requirements
• Monitor and evaluate network performance, addressing gaps and opportunities for improvement
• Provide central management of contract inventory, renewals and amendments, ensuring all agreements are up-to-date and compliant with organizational policies and regulations
• Provide guidance and support in contract negotiations and network management
• Lead a variety of provider operations such as credentialing, contract configuration and provider data management
• Ensure a cohesive provider experience through leadership of provider success, provider communications, and provider marketing.  This includes partnering with Provider Relations and other operational areas such as Claims
• Collaborate with other departments, such as sales, marketing, and operations, to align network strategy with organizational goals
• Partner with technology to develop necessary tools and processes to manage Oscar’s networks
• Foster positive relationships with key stakeholders, including healthcare providers, professional organizations, industry and strategic partners, and community partners
• Compliance with all applicable laws and regulations
• Other duties as assigned

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