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Remote Provider Network Development Jobs in Georgia

AutomationDirect

Network Administrator

Cumming, GA · Remote

Maintain the current environment and provide daily network support for the company * Review ... remote access, network segmentation, access control, and secure connectivity between internal ...

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Remote Provider Network Development information

What is a remote provider network development specialist?

A Remote Provider Network Development specialist is responsible for identifying, recruiting, and managing healthcare providers to join a health plan’s network, all while working remotely. They negotiate contracts, ensure providers meet quality standards, and maintain strong relationships to ensure network adequacy. This role often involves analyzing data to identify network gaps and collaborating with internal teams to address member needs. Remote work allows these specialists to connect with providers across various regions without needing to be on-site.

What are some common challenges faced by professionals in remote provider network development roles and how can they be addressed?

One of the main challenges in Remote Provider Network Development is building strong relationships with providers and stakeholders without regular face-to-face interaction. This requires effective virtual communication skills and the ability to leverage digital collaboration tools. Additionally, navigating differing regulations and provider expectations across regions can be complex, so staying organized and informed about local requirements is crucial. Proactively scheduling regular check-ins and utilizing centralized documentation can help maintain alignment and foster trust among network partners.

What are the key skills and qualifications needed to thrive as a remote provider network development professional, and why are they important?

To excel in Remote Provider Network Development, you need expertise in healthcare network management, contract negotiation, and provider relations, often supported by a bachelor’s degree in healthcare administration or a related field. Familiarity with health plan software, CRM tools, and knowledge of regulatory compliance systems are typically required. Strong communication, relationship-building, and problem-solving skills are essential for establishing and maintaining provider partnerships. These skills ensure effective network expansion, regulatory compliance, and high-quality service for health plan members.

What is the difference between Remote Provider Network Development vs Remote Provider Relations Specialist?

AspectRemote Provider Network DevelopmentRemote Provider Relations Specialist
Primary FocusBuilding and expanding provider networks, negotiating contractsManaging existing provider relationships, resolving issues
Required CredentialsHealthcare administration, insurance, or related certificationsCustomer service, healthcare administration certifications
Work EnvironmentStrategic planning, cross-department collaborationProvider communication, issue resolution
Industry UsageHealth insurance companies, managed care organizations

Remote Provider Network Development focuses on expanding and negotiating provider networks, while Remote Provider Relations Specialists manage ongoing provider relationships and address issues. Both roles require healthcare or insurance knowledge but differ in their strategic versus operational focus.

What are the most commonly searched types of Provider Network Development jobs in Georgia?

The most popular types of Provider Network Development jobs in Georgia are:

What are popular job titles related to Remote Provider Network Development jobs in Georgia?

For Remote Provider Network Development jobs in Georgia, the most frequently searched job titles are:

What job categories do people searching Remote Provider Network Development jobs in Georgia look for?

The top searched job categories for Remote Provider Network Development jobs in Georgia are:

What cities in Georgia are hiring for Remote Provider Network Development jobs?

Cities in Georgia with the most Remote Provider Network Development job openings:

Remote Provider Network Development jobs near you

Senior Director, Network Contracting

Atlanta, GA • Remote

Oscar Health
Insurance Services • 1 - 5K employees

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

261st of 312 rated insurance

Respectful managers

Uninterrupted breaks

Learn more about Oscar Healthexternal

$178K - $234K/yr

Full-time

PTO

Posted 20 days ago

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: Atlanta, Georgia. 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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