Sr. Network Contracting Specialist

About the role:

You will help support the Specialty Contracting team. You will focus on National Ancillary Agreements, Single Case Agreements (SCAs), and Independent Dispute Resolution (IDR). Key responsibilities include negotiating and managing contracts with healthcare providers to establish and maintain a national ancillary network. You will ensure access to quality care and optimize costs by analyzing provider performance and negotiating reimbursement rates, often navigating complex contract terms and regulatory compliance. Additionally, you will helps recruit new national ancillary providers, resolving provider issues, and contributing to cost-saving initiatives.

You will report into the Senior Director, Speciality Contracting.

Work Location:

This is a remote position based in the field, open to candidates who reside: Arizona, California, Florida, Illinois, Iowa, Kansas, Michigan, Mississippi, Missouri, New York, Nebraska, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, or 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.

Responsibilities:

• 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.
• With support from your leader, uses 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.
• With input and support from their leader, 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 to ensure network stability and quality.
• 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

Requirements:

• 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.

EEO:

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.