Hi, we're Oscar. We're hiring a Senior Manager to join our Network Contracting & Services team.

Oscar is the first health insurance company built around a full stack technology platform & a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family.

About the role:

The Senior Manager, Network Contracting & Services leads a team focused on negotiating & managing complex contracts with large healthcare providers (groups/hospital systems) in Oscars Southeast markets. This role is the primary relationship manager for key providers, optimizing for productive, long-term partnerships while meeting accessibility, quality, & financial goals. The position requires extensive provider management & negotiation skills, claims knowledge, & collaboration with internal & external stakeholders to achieve successful provider outcomes, support cost savings, & grow the regional provider network.

You will report into the Director, Network Contracting & Services.

Work Location: This is a remote position based in the field, open to candidates who reside in: Georgia, North Carolina, New York, South Carolina or Tennessee. Your daily work will involve a blend of work from your home office & frequent local travel for client meetings. Occasional travel may be required for team meetings & company events. #LI-Remote

Travel up to 25%

Pay Transparency: The base pay for this role in New Jersey or New York is: $119,200 - $156,450 per year. The base pay for this role in all other locations is: $107,280 - $140,805 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program & annual performance bonuses.

Responsibilities:

• Conducts comprehensive reviews & analyses of provider contracts, identifying & surfacing areas for improvement & optimization to appropriate stakeholders
• Oversee a team of provider network managers, including specialists & associates, contracting managers, associates & specialists facilitating leadership, guidance, & mentorship by setting strategic objectives, monitoring team performance, providing training & development opportunities, & fostering a collaborative & innovative work environment.
• Leads high-importance claims dispute and/or settlement negotiations, striving to reach mutually beneficial agreements with providers that maintain & enhance the provider network.
• Manage & negotiate complex contracts with healthcare providers, including Value Based Care agreements, focusing on favorable terms & compliance with organizational standards & regulatory requirements.
• Utilizes working knowledge of provider financial issues & competitor strategies to inform negotiation & contracting decisions.
• Drive Implementation across the contracting team of contracting policies & workflows; ensure effective & efficient contracting processes are in place.
• Monitor & analyze key metrics for network performance, cost, & provider satisfaction, & provide reports to leadership.
• Ensure you & your team provide timely resolution of provider issues related to contract terms, reimbursement, & network participation.
• Build & maintain positive relationships with healthcare providers to ensure network stability & quality
• Compliance with all applicable laws & regulations
• Other duties as assigned

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 & negotiating complex contracts
• 3+ years of leadership experience
• 3+ years experience in Health Insurance (Individual and/or Medicare Advantage) and/or Healthcare industry

Bonus points:

• Bachelor's degree or equivalent professional working experience.
• Provider management experience with healthcare systems/hospitals at managed care company