[Hiring] Sr. Network Contracting Specialist @Oscar Health

Role Description

Hi, we're Oscar. We're hiring a Sr. Network Contracting Specialist to join our Specialty Contracting team. You will help support the Specialty Contracting team, focusing on:

• National Ancillary Agreements
• Single Case Agreements (SCAs)
• Independent Dispute Resolution (IDR)

Key responsibilities include:

• Negotiating and managing contracts with healthcare providers to establish and maintain a national ancillary network.
• Ensuring access to quality care and optimizing costs by analyzing provider performance and negotiating reimbursement rates.
• Navigating complex contract terms and regulatory compliance.
• Recruiting new national ancillary providers and resolving provider issues.
• Contributing to cost-saving initiatives.

You will report into the Senior Director, Specialty Contracting.

Work Location: This is a remote position based in the field, open to candidates who reside in:

• Arizona
• California
• Florida
• Illinois
• Iowa
• Kansas
• Michigan
• Mississippi
• Missouri
• New York
• Nebraska
• North Carolina
• Ohio
• Pennsylvania
• South Carolina
• Tennessee
• Texas
• Virginia

Your daily work will involve a blend of work from your home office and frequent travel for client meetings. #LI-Remote

Pay Transparency: The base pay for this role in New York and California is: $96,876 - $127,149 per year. All other locations base pay is: $71,539 - $93,895 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

Qualifications

• 2+ years of experience in provider network operations or contracting or provider services.
• 1+ years of experience in Health Insurance and/or Healthcare industry.
• 1+ years experience navigating and organizing large datasets such as claim files and provider rosters.

• Bonus points: Associate's degree or equivalent professional working experience.

Requirements

• Support and direct involvement with negotiating contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards, strategy, and regulatory requirements.
• Negotiate Single Case Agreements (SCA's) and Independent Dispute Resolution (IDR) cases.
• Conduct comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization.
• Use data and analytics of provider financial issues and competitor strategies to inform negotiation and contracting decisions.
• Support implementation of contracting policies and workflows; monitor and 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 for assigned provider accounts.
• Build and maintain positive relationships with healthcare providers and ensure timely and professional resolution of provider issues.
• Help track and analyze key performance indicators (KPIs) to monitor provider satisfaction and operational efficiency.
• 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.
• 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.