Senior Manager, Network Contracting & Services - Southeast Region

Oscar Health•Atlanta, GA

2d•$107,280 - $140,805•Remote

About The Position

The Senior Manager, Network Contracting & Services leads a team focused on negotiating and managing complex contracts with large healthcare providers (groups/hospital systems) in Oscar’s Southeast markets. This role is the primary relationship manager for key providers, optimizing for productive, long-term partnerships while meeting accessibility, quality, and financial goals. The position requires extensive provider management and negotiation skills, claims knowledge, and collaboration with internal and external stakeholders to achieve successful provider outcomes, support cost savings, and grow the regional provider network. You will report into the Director, Network Contracting & Services. Work Location: This is a remote position based in the field, open to candidates who reside in: Georgia, North Carolina, New York, South Carolina or Tennessee. Your daily work will involve a blend of work from your home office and frequent local travel for client meetings. Occasional travel may be required for team meetings and company events.

Requirements

6+ years in healthcare network contracting, including executing contracts with health systems, hospitals or national providers, provider relations, or network management
4+ years of experience managing complex Provider Network strategies and negotiating complex contracts
3+ years of leadership experience
3+ 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.
Provider management experience with healthcare systems/hospitals at managed care company

Responsibilities

Conducts comprehensive reviews and analyses of provider contracts, identifying and surfacing areas for improvement and optimization to appropriate stakeholders
Oversee a team of provider network managers, including specialists and associates, contracting managers, 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.
Leads high-importance claims dispute and/or settlement negotiations, striving to reach mutually beneficial agreements with providers that maintain and enhance the provider network.
Manage and negotiate complex contracts with healthcare providers, including Value Based Care agreements, focusing on favorable terms and compliance with organizational standards and regulatory requirements.
Utilizes working knowledge of provider financial issues and competitor strategies to inform negotiation and contracting decisions.
Drive Implementation across the contracting team of contracting policies and workflows; ensure effective and efficient contracting processes are in place.
Monitor and analyze key metrics for network performance, cost, and provider satisfaction, and provide reports to leadership.
Ensure you and your team provide 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