Manager, National Provider Contracting

Oscar Health•Dallas, TX

5d•$100,602 - $146,711•Remote

About The Position

Oscar is seeking a Provider Contracting Manager to join its National Contracting team. This role is responsible for leading a team that negotiates, executes, and analyzes contracts with large, national, and/or complex healthcare group/system providers. The goal is to maintain and enhance the provider network while meeting accessibility, quality, and financial objectives. The Manager will manage an assigned portfolio of large national ancillary providers and/or multi-state health systems throughout the contracting lifecycle, including market assessment, recruitment, negotiation, implementation, performance management, renewal, and escalation. This role collaborates with Network leadership and cross-functional partners to translate network access and affordability goals into executable contract strategies, utilizes data to inform negotiations, and maintains strong provider relationships. The position reports to the Senior Director, Specialty Contracting.

Requirements

4+ years in healthcare network contracting, including executing contracts with health systems, hospitals or national providers, provider relations, or network management
2+ years of experience managing complex Provider Network strategies and negotiating complex contracts
2+ years of people management experience
2+ years experience in Health Insurance (Individual and/or Medicare Advantage) and/or Healthcare industry

Nice To Haves

Bachelor'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.
Oversee a small team of contracting associates and specialists, facilitating leadership, guidance, and mentorship by setting strategic objectives, monitoring team performance, providing training and development opportunities, and fostering a collaborative and innovative work environment.
Conducts 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 inform negotiation and contracting decisions and to support the team in doing so.
Key player in implementation of contracting policies and workflows; monitors and ensures effective and efficient contracting processes are in place.
Monitor key metrics for network performance, cost, and provider satisfaction, and provide reports to leadership for assigned accounts.
Ensure you and your team are providing timely resolution of provider issues related to contract terms, reimbursement, and network participation.
Build and maintain positive relationships with healthcare providers to ensure network stability and quality.
Compliance with all applicable laws and regulations
Other duties as assigned