[Hiring] Senior Specialist, Network Contracting @Oscar Health

Role Description

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.
• Utilize 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.

Qualifications

• 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.

Requirements

• Associates degree or equivalent professional working experience (bonus points).

Benefits

• Base pay for this role is $71,539.20 - $93,895.20 per year.
• Eligible for employee benefits, unlimited PTO, and annual performance bonuses.
• Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.