We're hiring a Manager to join our Network Contracting Team.
About the role:The Manager, Network Contracting & Services is responsible for managing a team of individuals who support specific healthcare providers in Oscar's network (hospital/health systems and individual provider groups) to build and maintain a robust network in assigned market/region; while also ensuring access to quality care and optimizing costs by analyzing provider performance and negotiating reimbursement rates, often involving complex contract terms and compliance with regulatory guidelines. The Manager also supports network growth and recruiting efforts by engaging with prospective providers directly; assisting with resolution of provider issues; supporting cost- saving initiatives; executing the local network strategy; and ensuring providers across our service area have the information and support they need to provide best-in-class member care.
You will report into the Senior Director, Network Contracting & Services.
Work Location: This is a remote position based in the field, open to candidates who reside Florida. Your daily work will involve a blend of work from your home office and frequent local travel for client meetings. Occasional travel may be required for team meetings and company events. #LI-Remote
Pay Transparency: The base pay for this role is $100,602 - $132,040 per year You are also eligible for employee benefits, unlimited PTO, and annual performance bonuses.
Responsibilities:- Implement contracting strategies under the direction of Network Lead 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.
- 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.
- Monitor team performance for 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.
Requirements:- 6+ years in healthcare network contracting, including executing contracts with health systems, hospitals or national providers, provider relations, or network management
- 4+ years of experience managing complex Provider Network strategies and negotiating complex contracts
- 3+ years experience in Health Insurance (Individual and/or ACA Market Place) and/or Healthcare industry
Bonus points:- Bachelor's degree or equivalent professional working experience.
- 3+ years of leadership experience
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Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. 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, and paid wellness time and reimbursements.
Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.
