Associate, Network Contracting

Oscar Health•Alabama, United States, AL

1d•$87,560 - $114,434•Remote

About The Position

Oscar is seeking an Associate, Network Contracting to join their Specialist Contracting team. This role is responsible for managing contracts with key healthcare providers (hospital/health systems and large national ancillary groups) to build and maintain a robust network. The position ensures access to quality care and optimizes costs by analyzing provider performance and negotiating reimbursement rates, which involves complex contract terms and compliance with regulatory guidelines. Key functions include supporting cost-saving initiatives, executing national network strategy, ensuring high-performing network development, and ensuring providers have the necessary information and support to deliver excellent member care. The role reports to the Senior Director, Speciality 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

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.
Support comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization.
Utilize 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