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Provider Contracting Network Manager Jobs in Texas

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Senior Director, Network Contracting

Dallas, TX · On-site

$178K - $234K/yr

The Senior Director of Network Contracting is responsible for developing and managing complex provider network strategies, negotiating complex contracts, and fostering strong relationships with ...

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Provider Contracting Network Manager information

What is a provider contracting network manager?

Provider Contracting Network Managers are professionals responsible for developing and maintaining relationships between healthcare organizations and medical service providers. They negotiate contracts that define the terms of service, reimbursement rates, and performance expectations to ensure quality care is delivered cost-effectively. These managers analyze network adequacy, monitor provider performance, and ensure compliance with regulatory standards. Their role is crucial in building a robust provider network that meets the needs of patients and the organization.

What are the key skills and qualifications needed to thrive as a provider contracting network manager?

To thrive as a Provider Contracting Network Manager, you need expertise in contract negotiation, healthcare regulations, and provider relations, typically supported by a bachelor's degree in business, healthcare administration, or a related field. Familiarity with contract management software, data analytics tools, and knowledge of payer systems or credentialing platforms is often required. Strong interpersonal, communication, and analytical skills help build productive relationships and navigate complex negotiations. These competencies are essential to ensure competitive provider networks, regulatory compliance, and the financial success of healthcare organizations.

What are some common challenges faced by provider contracting network managers, and how can they effectively address them?

Provider Contracting Network Managers often encounter challenges such as negotiating competitive rates with providers, ensuring compliance with regulatory requirements, and maintaining strong relationships with both internal stakeholders and external partners. To address these, it is crucial to stay updated on industry trends, foster transparent communication, and leverage data analytics to inform contract decisions. Building a collaborative environment with providers and cross-functional teams also helps in managing expectations and achieving mutually beneficial agreements.

What cities in Texas are hiring for Provider Contracting Network Manager jobs?

Cities in Texas with the most Provider Contracting Network Manager job openings:

Senior Director, Network Contracting

Dallas, TX • Remote

Oscar Health
Insurance Services • 1 - 5K employees
Learn more about Oscar Healthexternal

$178K - $234K/yr

Full-time

PTO

Re-posted 6 days ago

Oscar Health rating

6.6

Company rating: 6.6 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

Job description

Hi, we're Oscar. We're hiring a Senior Director to join our Network Contracting.

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 Senior Director of Network Contracting is responsible for developing and managing complex provider network strategies, negotiating complex contracts, and fostering strong relationships with healthcare providers, facilities, and ancillary organizations for complex This role leads the market provider contracting team and collaborates with key internal and external stakeholders to enhance network performance, manage costs, and ensure high-quality care delivery. This role is responsible for developing and implementing strategies related to network development, cost containment, and relationship management with healthcare providers that align with organizational goals within a specific market/region.

You will report into the Vice President, Network Management.

Work Location: This is a remote position, open to candidates who reside in: Dallas, Texas. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

Pay Transparency: The base pay for this role is: $178,848 - $234,738 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

  • Develop and implement complex contracting strategies in partnership with multiple Market Leaders that align with the company's overall network development and cost management objectives.
  • Lead and mentor the provider contracting team, setting clear goals and expectations.
  • Collaborate with the Network Monitoring & Performance team to identify network gaps and develop strategies to expand provider relationships and access to care.
  • If necessary, be able to source and identify OON provider targets that align with Oscars overall Market strategy
  • Lead complex contract negotiations with hospitals, physicians, ancillary service providers, and other healthcare entities.
  • Develop and execute standard and complex contracting agreements that drive financial performance, ensure access to quality care, and support cost control efforts.
  • Ensure timely resolution of provider issues related to contract terms, reimbursement, and network participation.
  • Ensure all provider agreements comply with relevant federal, state, and local regulations.
  • Act as a primary point of contact between the organization and healthcare providers for contracting-related activities.
  • Build and maintain strong working relationships with providers to foster collaboration and network stability.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • 12+ years of experience in healthcare provider contracting, network development, or related areas.
  • 7+ years experience negotiating complex contracts with hospitals, physician groups, and other healthcare providers.
  • 5+ years of leadership or managerial experience in a healthcare setting.

Bonus points:

  • Strong understanding of healthcare delivery systems, reimbursement models, and managed care principles.

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