Associate, Network Contracting – Northeast Region

This is a fully remote position, open to applicants in New York.

📋 Description

• Oversee contracts with essential healthcare providers within Oscar's network.

• Develop and sustain a strong network within the designated market or region.

• Evaluate provider performance and negotiate reimbursement rates effectively.

• Engage with potential providers to foster network expansion and recruitment efforts.

• Assist in resolving issues faced by providers.

• Support initiatives aimed at cost savings.

• Implement the local network strategy efficiently.

• Ensure that providers are equipped with the necessary information and support to deliver member care.

• Execute contracting strategies that align with objectives related to network adequacy, development, and cost management.

• Manage and negotiate contracts with designated healthcare providers.

• Review and assess provider contracts to identify areas for improvement and optimization.

• Utilize financial data from providers and competitor strategies to guide negotiation and contracting decisions.

• Achieve metrics for provider outreach and contract completion as well as service level agreements (SLAs).

• Collaborate with provider services to enhance servicing, education, and communication efforts.

• Monitor the assigned networks for compliance and formulate corrective action plans as necessary.

• Adhere to all relevant laws and regulations.

• Report directly to the Manager of Network Contracting.

⛳️ Requirements

• A minimum of 3 years' experience in healthcare client management, consulting, provider contracting, operations, or a related field.

• At least 2 years' experience in supporting the development of provider network strategies and negotiating contracts with providers.

• Over 1 year of experience conducting financial analyses on markets or product lines and collaborating cross-functionally to identify improvement opportunities.

• More than 1 year of experience in organizing and navigating large datasets, such as claims files and provider rosters.

• An Associate's degree or equivalent professional experience is considered a plus.

🏝️ Benefits

• Comprehensive employee benefits.

• Unlimited vacation policy.

• Annual performance-based bonuses.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• 11 paid holidays.

• Paid sick leave.

• Paid parental leave.

• Participation in a 401(k) plan.

• Life and disability insurance.

• Paid wellness time and reimbursement options.

• Reasonable accommodations provided during the application process.