Associate, National Provider Contracting

This is a fully remote position, open to applicants in Alabama, +14 more states.

📋 Description

• Assist in the formulation and implementation of national contracting strategies for major ancillary providers and/or health systems.

• Oversee a designated portfolio throughout the entire contracting lifecycle, which includes prospecting, analysis, negotiation, execution, performance oversight, renewal, and termination.

• Prepare for and negotiate intricate provider agreements that encompass reimbursement, operational, data-sharing, performance, and compliance terms.

• Collaborate with Legal, Finance, Provider Operations, Claims, Credentialing, Configuration, Compliance, and Market teams to ensure contract implementation.

• Foster and sustain relationships with leaders in provider contracting and operations.

• Conduct regular business reviews, address escalated issues, and coordinate corrective action plans.

• Evaluate claims, utilization, reimbursement, provider rosters, market conditions, and competitive data to formulate negotiation strategies and assess financial implications.

• Supervise assigned networks and assess provider performance regarding access, adequacy, quality, cost, and adherence to contractual obligations.

• Identify risks and assist in remediation efforts with Network and Market leadership.

• Maintain an accurate contracting pipeline, status updates, documentation, and provider information.

• Achieve established service-level agreements and performance metrics related to outreach, negotiations, and contract finalization.

• Adhere to all relevant laws and regulations.

• Perform additional duties as assigned.

• Report directly to the Senior Director of Specialty Contracting.

⛳️ Requirements

• A minimum of 3 years of experience in provider contracting, provider network management, healthcare consulting, healthcare operations, or a comparable field.

• At least 2 years of experience in supporting provider network strategy and negotiating provider agreements.

• Proven experience managing intricate, multi-stakeholder contracting processes from analysis and negotiation to implementation and ongoing performance management.

• Experience in establishing effective relationships with provider contracting and operational leaders, along with communicating recommendations to internal stakeholders.

• At least 1 year of experience conducting financial analysis for healthcare markets, provider contracts, or product lines, and converting findings into negotiation or improvement opportunities.

• A minimum of 1 year of experience working with large datasets, including claims, utilization, fee schedules, contract inventories, and provider rosters.

• Bachelor's degree in business, healthcare administration, finance, economics, or a related field, or equivalent professional experience.

• Experience in contracting with national ancillary provider organizations, multi-state provider groups, or large health systems.

• Familiarity with provider reimbursement methodologies, contract language, claims data, network adequacy, and provider operations.

• Candidates must reside in Alabama, Arizona, California, Florida, Illinois, Iowa, Kansas, Michigan, Mississippi, Missouri, Nebraska, New York, North Carolina, Ohio, or Texas.

🏝️ Benefits

• Annual performance bonuses.

• Comprehensive employee benefits.

• Oscar's unlimited vacation program.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 11 paid holidays.

• Paid sick time.

• Paid parental leave.

• Participation in a 401(k) plan.

• Life insurance coverage.

• Disability insurance.

• Paid wellness time.

• Wellness reimbursements.

• Occasional travel for team meetings and company events.