Associate, Network Contracting & Services (Florida)

Oscar Health•Florida, United States, FL

1d•$87,188 - $114,434•Remote

About The Position

Oscar is seeking an Associate to join its Network Contracting & Services team. This role is responsible for managing contracts with key healthcare providers (hospitals/health systems and individual provider groups) to build and maintain a robust network in assigned markets/regions. The Associate will ensure access to quality care and optimize costs by analyzing provider performance and negotiating reimbursement rates, which involves complex contract terms and regulatory compliance. Additionally, the role supports network growth and recruiting by engaging with prospective providers, resolving provider issues, supporting cost-saving initiatives, executing local network strategy, and ensuring providers have the necessary information and support for member care.

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

Implement contracting strategies under the direction of Network Director and/or Senior 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.
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.
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