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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 of Network Contracting & Services is responsible for leading a team of direct & indirect reports focused on negotiating, executing, & analyzing contracts with large, national and/or complex healthcare group/system providers, focusing on maintaining & enhancing the provider network while meeting accessibility, quality, & financial goals. The Senior Manager handles dispute resolution & settlement negotiations, ensuring compliance with company standards & regulatory requirements. This role leverages extensive negotiation skills & working knowledge of provider claims to optimize contracts, & collaborates with providers, hospitals & health systems to achieve successful contracting outcomes & relationships, all while supporting cost-saving initiatives & the growth of the provider network for the Northeast region.
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: New Jersey, New York, Ohio, Pennsylvania, or Virginia. 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:
- Help inform & drive Implementation of contracting strategies in partnership with Market Leaders that align with the company's overall network adequacy, development & cost management objectives.
- Leads contract settlement negotiations, striving to reach mutually beneficial agreements with providers that maintain & enhance the provider network.
- Manage & negotiate complex contracts, including Value Based Care agreements, with healthcare providers, focusing on favorable terms & compliance with organizational standards & regulatory requirements.
- Oversee a team of 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.
- Conducts comprehensive reviews & analyses of provider contracts, identifying & surfacing areas for improvement & optimization to appropriate stakeholders
- 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.
- Experience with Value Based Care contracting
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves & find both belonging & support. We're on a mission to change health care -- an experience made whole by our unique backgrounds & perspectives.
Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, & experience. Full-time employees are eligible for benefits including: medical, dental, & vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life & disability insurance, & paid wellness time & reimbursements.
Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates & detail how we use AI to support our recruiting efforts.
Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicants disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.
California Residents: For information about our collection, use, & disclosure of applicants personal information as well as applicants rights over their personal information, please see our Privacy Policy.
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