Provider Network Remote Jobs in Philadelphia, PA

Hi We're Oscar. We're hiring a Manager to join our Network Contracting 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 Manager of Network Contracting is responsible for leading a team of direct reports focused on negotiating, executing, and analyzing contracts with large, national and/or complex healthcare group/system providers, focusing on maintaining and enhancing the provider network while meeting accessibility, quality, and financial goals. The Manager, Network Contracting handles dispute resolution and settlement negotiations, ensuring compliance with company standards and regulatory requirements. This role leverages negotiation skills and working knowledge of provider financial issues to optimize contracts, and collaborates with providers, hospitals and health systems to achieve successful contracting outcomes, all while supporting cost-saving initiatives and the growth of the provider network for a defined market or region.

You will report into the Director, Network Contracting & Services.

Work Location: This is a remote position based in the field, open to candidates who reside in New Jersey, New York, Pennsylvania or Virginia. Your daily work will involve a blend of work from your home office and frequent local travel for client meetings. Occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role in New Jersey and New York is: $111,780 - $146,711. The base pay for this role in all other locations is $100,602 - $132,040 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

• Implement contracting strategies under the direction of Network Director and/or Senior Manager and in partnership with Market Leaders that align with the company's overall network adequacy, development and cost management objectives.
• Manage and negotiate contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards and regulatory requirements.
• Oversee a small team of contracting associates and specialists, facilitating leadership, guidance, and mentorship by setting strategic objectives, monitoring team performance, providing training and development opportunities, and fostering a collaborative and innovative work environment.
• Conducts comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization.
• Utilizes data and analytics of provider financial issues and competitor strategies to inform negotiation and contracting decisions and to support the team in doing so.
• Key player in implementation of contracting policies and workflows; monitors and ensures effective and efficient contracting processes are in place.
• Monitor key metrics for network performance, cost, and provider satisfaction, and provide reports to leadership for assigned accounts.
• Ensure you and your team are providing timely resolution of provider issues related to contract terms, reimbursement, and network participation.
• Build and maintain positive relationships with healthcare providers to ensure network stability and quality.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• 4+ years in healthcare network contracting, including executing contracts with health systems, hospitals or national providers,  provider relations, or network management
• 2+ years of experience managing complex Provider Network strategies and negotiating complex contracts
• 2+ years of people management experience
• 2+ years experience in Health Insurance (Individual and/or Medicare Advantage) and/or Healthcare industry

Bonus points:

• Bachelor's degree or equivalent professional working experience