Associate, Network Contracting & Services (Texas + West Region)

Oscar Health•Tempe, AZ

5d•$87,188 - $114,434•Remote

About The Position

Oscar is seeking an Associate to join their Network Contracting & Services team. This role is responsible for negotiating and managing contracts with healthcare providers 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 often involves complex contract terms and compliance with regulatory guidelines. Additionally, the Associate will support network growth and recruiting efforts by engaging with prospective providers, resolving provider issues, supporting cost-saving initiatives, assisting with local network strategy design and execution, and ensuring providers have the necessary information and support for member care. The position reports to the Director, Network Contracting & Services.

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.
Serve as a Subject Matter Expert to a small team of contracting specialists and/or analysts, 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.