Associate, National Ancillary Contracting

Oscar Health•New York City, NY

4d•Hybrid

About The Position

The Associate is crucial to the Specialty Contracting team. This role focuses on recruitment and account management for National Ancillary providers. This ensures access to quality care and optimizes costs by analyzing provider performance and negotiating reimbursement rates, often involving complex contract terms and regulatory compliance. The Associate also supports network growth and recruiting by directly engaging with prospective providers, assisting with provider issue resolution, supporting cost-saving initiatives, helping design and execute the national ancillary network strategy, and ensuring providers have the necessary information and support to deliver excellent member care. You will report into the Senior Director, Specialty Contracting.

Requirements

3+ years of experience in healthcare client management, healthcare consulting, or provider healthcare contracting, healthcare operations, or a related field
2+ years of experience supporting provider network strategy development and negotiating provider contracts
1+ years experience running financial analyses on a markets or product lines, and working cross-functionally to support driving improvement opportunities
1+ years experience navigating and organizing large data sets such as claim files and provider rosters

Nice To Haves

Associate's degree or equivalent professional working experience.

Responsibilities

Support Implementation of contracting strategies under the direction of Network Director and/or Manager 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.
Negotiate Single Case Agreements (SCA's) and Independent Dispute Resolution (IDR) cases.
Serve as a Subject Matter Expert providing guidance and fostering a collaborative and innovative work environment.
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.
Facilitates guidance and mentorship of more junior team members by reiterating strategic objectives, providing training and development opportunities, and fostering a collaborative and innovative work environment
Supports implementation of contracting policies and workflows; supports identifying when effective and efficient contracting processes need improvement
Meet 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.
Compliance with all applicable laws and regulations
Other duties as assigned