Senior Manager, Network Contracting - Southeast Region

Hi, we're Oscar. We're hiring a Senior Manager to join our Network Contracting & Services 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 Senior Manager of Network Contracting & Services is responsible for leading a team of direct and indirect 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 Senior Manager handles dispute resolution and settlement negotiations, ensuring compliance with company standards and regulatory requirements. This role leverages extensive negotiation skills and working knowledge of provider claims to optimize contracts, and collaborates with providers, hospitals and health systems to achieve successful contracting outcomes and relationships, all while supporting cost-saving initiatives and the growth of the provider network for the Southeast 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: Alabama, Georgia, Tennessee, North Carolina, or New York. 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

Travel up to 25%

Pay Transparency: The base pay for this role in New Jersey or New York is: $119,200 - $156,450 per year. The base pay for this role in all other locations is: $107,280 - $140,805 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

• Help inform and drive Implementation of contracting strategies in partnership with Market Leaders that align with the company's overall network adequacy, development and cost management objectives.
• Leads contract settlement negotiations, striving to reach mutually beneficial agreements with providers that maintain and enhance the provider network.
• Manage and negotiate complex contracts, including Value Based Care agreements, with healthcare providers, focusing on favorable terms and compliance with organizational standards and regulatory requirements.
• Oversee a team of contracting managers, 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 provider contracts, identifying and surfacing areas for improvement and optimization to appropriate stakeholders
• Utilizes working knowledge of provider financial issues and competitor strategies to inform negotiation and contracting decisions.
• Drive Implementation across the contracting team of contracting policies and workflows; ensure effective and efficient contracting processes are in place.
• Monitor and analyze key metrics for network performance, cost, and provider satisfaction, and provide reports to leadership.
• Ensure you and your team provide 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:

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

Bonus points:

• Bachelor's degree or equivalent professional working experience.
• Experience with Value Based Care contracting