Manager, Network Contracting & Services

Oscar Health•Philadelphia, PA

14h•Remote

About The Position

You will be 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. You will handle dispute resolution and settlement negotiations, ensuring compliance with company standards and regulatory requirements. You will leverage extensive 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, Northeast Network. Work Location: This is a remote position based in the field, open to candidates who reside in: Ohio, Michigan, or Pennsylvania. 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.

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 experience in Health Insurance (Individual and/or ACA Market Place) and/or Healthcare industry

Nice To Haves

Bachelor's degree or equivalent professional working experience.
3+ years of leadership experience

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.
Lead contract settlement negotiations, striving to reach mutually beneficial agreements with providers that maintain and enhance the provider network.
Manage and negotiate complex contracts with healthcare providers, focusing on favorable terms and compliance with organizational standards and regulatory requirements.
Work cross-functionally with 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
Utilize 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