Associate, Value Based Contracting

Oscar Health•Remote, FL

3d•$87,188 - $127,149•Remote

About The Position

Oscar is seeking a Value Based Contracting Associate to join their Network Contracting team. This role supports the negotiation and execution of Value Based Contracts to build and maintain a robust network, ensuring access to quality care and optimizing costs. The Associate will analyze provider performance, negotiate reimbursement rates, and engage with prospective providers to support network growth. They will also assist in resolving provider issues, supporting cost-saving initiatives, and ensuring providers have the necessary information and support for best-in-class member care. The role reports to the Manager, Value Based 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.
Experience with Value Based Contracting

Responsibilities

Implement Value Based Contracting strategies under the direction of Network 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.