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Associate, Network Contracting (Northeast Region)

Oscar Health · Business Operations

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Where
New York, New York, United States
Posted
Sep 1

Hi, we're Oscar. We're hiring an Associate 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.

What you'd do

  • 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.
  • Supports 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 support informing negotiation and contracting decisions.
  • Meet defined metrics and SLAs including but not limited to provider outreach and contract completion.
  • Collaborate with the provider services team regarding the servicing, education and communication to our provider network.
  • Monitor assigned networks to gauge compliance with standards, developing corrective action plans with network contracting and market leadership to remediate deficiencies.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

What they want

  • 3+ years of experience in healthcare client management, healthcare consulting, or provider healthcare contracting, healthcare operations, or a related field
  • 2+ years of experience supporting provider network strategy development and negotiating provider contracts
  • 1+ years experience running financial analyses on a markets or product lines, and working cross-functionally to support driving improvement opportunities
  • 1+ years experience navigating and organizing large data sets such as claim files and provider rosters

About Oscar Health · Business Operations

The Associate, Network Contracting & Services is responsible for managing contracts with key healthcare providers in Oscar's network (hospital/health systems and individual provider groups) to build and maintain a robust network in assigned market/region; while also ensuring access to quality care and optimizing costs by analyzing provider performance and negotiating reimbursement rates, often involving complex contract terms and compliance with regulatory guidelines.