Network Operations Manager Jobs in Red Bank, NJ (NOW HIRING)

Hi, we're Oscar. We're hiring a SVP, Network & Provider Management to join our Insurance team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The SVP, Network & Provider Management leader is a key player in Oscar's mission to enhance the quality and accessibility of care for members while supporting the organization's strategic goals. This role is directly responsible for crafting the overall network strategy, analyzing network adequacy and performance, articulating the engagement and experience standards for Oscar's providers, providing the necessary tooling to manage network build and maintenance while ensuring compliance with regulatory requirements. This role supports the development and management of Oscar Health Insurance's provider networks and contract negotiations, and leads a variety of network operations. This leader is key to ensuring Oscar meets its company goals and while providing network insights to support the line of business strategies.

You will report into the EVP. President of Oscar Insurance

Work Location: This position is based in our New York office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid

Pay Transparency: The base pay for this role is: $319,608 - $419,107 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

• Support Market leaders with network tooling, adequacy standards and contracting strategies
• Develop long-term strategies for network growth and optimization, addressing gaps in service coverage, and ensuring that the network adapts to changing healthcare trends and member needs.
• Utilize market trends and data to inform network strategy and identify opportunities for growth and improvement
• Ensure the development and maintenance of a comprehensive provider network, including hospitals, physicians, and ancillary providers.
• Demonstrating shared leadership in the overall insurance business by balancing the need to provide a broad network of services with controlling costs for both the company and policyholders through strong unit cost guidelines and contracting parameters.
• Monitor network adequacy and compliance with regulatory requirements.
• Monitor and evaluate network performance, addressing gaps and opportunities for improvement.
• Provide central management of contract inventory, renewals and amendments, ensuring all agreements are up-to-date and compliant with organizational policies and regulations.
• Provide guidance and support in contract negotiations and network management.
• Lead a variety of provider operations such as credentialing, contract configuration and provider data management
• Ensure a cohesive provider experience through leadership of provider success, provider communications, and provider marketing. This includes partnering with Provider Relations and other operational areas such as Claims.
• Collaborate with other departments, such as sales, marketing, and operations, to align network strategy with organizational goals.
• Partner with technology to develop necessary tools and processes to manage Oscar's networks.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• 20+ years experience in provider contracting, network management, or a related field within the healthcare or health insurance industry.
• 10+ years experience leading in matrixed organizations
• 10+ years experience building systems and processes to support provider network operations, from the ground up

Bonus points:

• Experience partnering with technology teams to optimize and evolve operational programs
• Demonstrated success in growing provider networks