Network Contracting & Services Associate
About The Position
The Associate, Network Contracting is responsible for negotiating and managing contracts with healthcare providers (hospital/health system and individual) to build and maintain a robust network in assigned market/region; while also ensuring access to quality care and optimizing costs by analyzing provider performance and negotiating reimbursement rates, often involving complex contract terms and compliance with regulatory guidelines. The Associate also supports network growth and recruiting efforts by engaging with prospective providers directly; assisting with resolution of provider issues; supporting cost-saving initiatives; assisting with the design and execution of the local network strategy; and ensuring providers across our service area have the information and support they need to provide best-in-class 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.
- 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
Benefits
- medical, dental, and vision benefits
- 11 paid holidays
- paid sick time
- paid parental leave
- 401(k) plan participation
- life and disability insurance
- paid wellness time and reimbursements
- Oscar's unlimited vacation program
- annual performance bonuses
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
