Senior Specialist, Network Contracting

Oscar Health•Florida, United States, FL

2h•$71,539 - $93,895•Remote

About The Position

The Senior Specialist of Network Contracting role is responsible for supporting the Associates and Managers improve contracting and relationship management with providers in Oscar's networks. The primary focus will be escalated issue resolution and problem solving on internal operational issues as it deals with providers' contractual issues. This will require work with our internal provider data, credentialing, and network operations teams to support relationships with key provider groups in a wide geography across FL. Support and direct involvement with issue resolution and negotiating contracts, focusing on favorable terms and compliance with organizational standards, strategy, and regulatory requirements. With support from your leader, utilizes data and analytics of provider financial issues and competitor strategies to inform business decisions. Adhere to defined metrics and SLAs including but not limited to provider outreach and contract completion. Build and maintain positive relationships with healthcare providers and ensure timely and professional resolution of provider issues to ensure network stability and quality. Collaborate with the provider services team regarding the servicing, education and communication to our provider network. Support provider onboarding, training, and resource distribution. Collaborate with internal teams such as Claims, Credentialing, and Contracting to resolve routine provider issues. Participate in process improvement initiatives to optimize workflows and enhance provider experience. You will report into the Senior Director, Network Contracting & Services. Work Location: This is a remote position based in the field, open to candidates who reside in florida. 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. #LI-Remote

Requirements

2+ years of experience in provider network operations or contracting or provider services
1+ years of experience in Health Insurance (Individual and/or Medicare Advantage) and/or Healthcare industry
1+ years experience navigating and organizing large data sets such as claim files and provider rosters

Nice To Haves

Associates degree or equivalent professional working experience.

Responsibilities

Support and direct involvement with issue resolution and negotiating contracts, focusing on favorable terms and compliance with organizational standards, strategy, and regulatory requirements.
With support from your leader, utilizes data and analytics of provider financial issues and competitor strategies to inform business decisions.
Adhere to defined metrics and SLAs including but not limited to provider outreach and contract completion.
Build and maintain positive relationships with healthcare providers and ensure timely and professional resolution of provider issues to ensure network stability and quality.
Collaborate with the provider services team regarding the servicing, education and communication to our provider network.
Support provider onboarding, training, and resource distribution.
Collaborate with internal teams such as Claims, Credentialing, and Contracting to resolve routine provider issues.
Participate in process improvement initiatives to optimize workflows and enhance provider experience.