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Remote Provider Network Management Jobs in Texas

Oscar Health

Senior Director, Network Contracting

Dallas, TX · Remote

$178K - $234K/yr

... 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 ...

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Oscar Health

Senior Director, Network Contracting

Dallas, TX · Remote

$178K - $234K/yr

... 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 ...

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Remote Provider Network Management information

What are the key skills and qualifications needed to thrive as a remote provider network management professional?

To thrive in Remote Provider Network Management, you need expertise in healthcare provider relations, contract negotiation, and a solid understanding of health plan regulations, often supported by a degree in healthcare administration or a related field. Familiarity with provider network management software, data analytics tools, and knowledge of regulations like HIPAA are typically required. Excellent communication, problem-solving abilities, and attention to detail are essential soft skills for building strong partnerships and managing network performance. These skills and qualifications ensure efficient network operations, regulatory compliance, and high-quality service for both providers and members.

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

AspectRemote Provider Network ManagementRemote Provider Relations Specialist
CredentialsHealthcare administration, network management certificationsCustomer service, healthcare communication certifications
Work EnvironmentHealthcare organizations, insurance companies, remote office settingsHealthcare providers, insurance companies, remote customer support
Industry UsageManaging provider networks, credentialing, contractingBuilding provider relationships, resolving provider issues

Remote Provider Network Management focuses on overseeing healthcare provider networks, including credentialing and contracting. In contrast, Remote Provider Relations Specialists primarily handle communication and relationship-building with providers. Both roles require healthcare knowledge but differ in their core responsibilities and focus areas.

How does a remote provider network management professional typically collaborate with healthcare providers and internal teams?

Remote Provider Network Management professionals frequently coordinate with healthcare providers via virtual meetings, emails, and secure online portals to address contract negotiations, credentialing, and performance issues. They also work closely with internal departments such as claims, quality assurance, and customer service to ensure seamless provider onboarding and ongoing support. Effective communication and strong relationship-building skills are essential, as much of the collaboration happens through digital channels. This setup allows for flexibility but requires self-motivation and proactive engagement to maintain strong provider networks.

What is remote provider network management?

A Remote Provider Network Management role involves overseeing relationships and contracts with healthcare providers, such as doctors, hospitals, and clinics, while working remotely. Professionals in this field are responsible for recruiting new providers, maintaining communication, ensuring compliance with regulations, and addressing network issues. They play a key part in expanding and maintaining a healthcare organization's provider network to ensure members have access to quality care. This job typically requires strong organizational, negotiation, and communication skills, as well as familiarity with healthcare regulations and provider credentialing processes.
What are popular job titles related to Remote Provider Network Management jobs in Texas? For Remote Provider Network Management jobs in Texas, the most frequently searched job titles are:
What job categories do people searching Remote Provider Network Management jobs in Texas look for? The top searched job categories for Remote Provider Network Management jobs in Texas are:
What cities in Texas are hiring for Remote Provider Network Management jobs? Cities in Texas with the most Remote Provider Network Management job openings:
Remote Provider Network Management jobs near you

VP, Network Management - Texas, Central, West Markets

Oscar Health

Dallas, TX • Remote

$240K - $315K/yr

Full-time

Posted 7 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

251st of 303 rated insurance

Job description

Hi, we're Oscar. We're hiring a VP, Network Management to join our Network 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 Vice President of Network Management is responsible for the contracting strategy, development, and management of a high-performing provider network for a defined geographic area within Oscar's footprint. This role oversees the strategic planning and execution of contracts that ensure a robust, cost-effective, and comprehensive provider network that meets the needs of our members, including provider account management & service. This leader collaborates with internal and external stakeholders to improve network performance, enhance provider relationships, ensure regulatory compliance, and drive high-quality, cost-effective care delivery.

You will report into the SVP, Network & Provider Management.

Work Location: This is a remote position, open to candidates who reside in: Arizona, California, Colorado, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Mexico, Ohio, Oregon, South Dakota, Texas, Utah, Washington or Wisconsin. A hybrid work schedule, with 3 days of in-office work per week, may be required depending on your metro area. #LI-Remote

Pay Transparency: The base pay for this role is: $240,120 - $315,157 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.

Responsibilities:

  • Lead the execution of short- and long-term strategic plans for provider network growth, alignment, and optimization.
  • Develop a strategy to enhance network adequacy, access, and member experience across multiple markets.
  • Oversee execution of provider contracting strategy, including value-based and fee-for-service contracting models, to improve care quality and control costs.
  • Build and maintain strong relationships with key health system leaders, hospital executives, and other network providers.
  • Negotiate and manage high-value, complex contracts to support cost containment and quality initiatives.
  • Monitor and analyze network performance metrics, including cost, utilization, quality, and member satisfaction.
  • Execute initiatives to enhance provider network performance, drive efficiencies, and improve member access to care.
  • Ensure that the provider network meets all state, federal, and accreditation standards for access, adequacy, and service.
  • Stay abreast of regulatory changes and industry best practices to ensure compliance and minimize risk.
  • Work with compliance and legal teams to address and mitigate risks related to provider contracting and network performance.
  • Lead, mentor, and develop a high-performing network management team to drive results and support professional growth.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • 15+ years of progressive experience in network management, provider relations, or health plan operations
  • 10+ years of leadership experience
  • 10+ years experience in provider contracting, negotiations, and building provider relationships.
  • 8+ years managing large provider networks within a health insurance or managed care setting.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

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.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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