VP, Network Management - Texas, Central, West Markets

Oscar Health•Texas, United States, TX

13d•$240,120 - $315,157•Remote

About The Position

The Vice President of Network Management is responsible for the contracting strategy, development, and management of a high-performing provider network for a defined geographic area within Oscar’s footprint. This role oversees the strategic planning and execution of contracts that ensure a robust, cost-effective, and comprehensive provider network that meets the needs of our members, including provider account management & service. This leader collaborates with internal and external stakeholders to improve network performance, enhance provider relationships, ensure regulatory compliance, and drive high-quality, cost-effective care delivery.

Requirements

15+ years of progressive experience in network management, provider relations, or health plan operations
10+ years of leadership experience
10+ years experience in provider contracting, negotiations, and building provider relationships.
8+ years managing large provider networks within a health insurance or managed care setting.

Responsibilities

Lead the execution of short- and long-term strategic plans for provider network growth, alignment, and optimization.
Develop a strategy to enhance network adequacy, access, and member experience across multiple markets.
Oversee execution of provider contracting strategy, including value-based and fee-for-service contracting models, to improve care quality and control costs.
Build and maintain strong relationships with key health system leaders, hospital executives, and other network providers.
Negotiate and manage high-value, complex contracts to support cost containment and quality initiatives.
Monitor and analyze network performance metrics, including cost, utilization, quality, and member satisfaction.
Execute initiatives to enhance provider network performance, drive efficiencies, and improve member access to care.
Ensure that the provider network meets all state, federal, and accreditation standards for access, adequacy, and service.
Stay abreast of regulatory changes and industry best practices to ensure compliance and minimize risk.
Work with compliance and legal teams to address and mitigate risks related to provider contracting and network performance.
Lead, mentor, and develop a high-performing network management team to drive results and support professional growth.
Compliance with all applicable laws and regulations
Other duties as assigned