Senior Specialist, Network Contracting

United Statessenior

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Quick Summary

Key Responsibilities

Support and direct involvement with issue resolution and negotiating contracts, focusing on favorable terms and compliance with organizational standards, strategy, and regulatory requirements.

Technical Tools

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Hi, we're Oscar. We're hiring a Senior Specialist to join our Network Contracting 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

~2 min read

The Senior Specialist of Network Contracting role is responsible for supporting the Associates and Managers improve contracting and relationship management with providers in Oscar's networks. The primary focus will be escalated issue resolution and problem solving on internal operational issues as it deals with providers' contractual issues. This will require work with our internal provider data, credentialing, and network operations teams to support relationships with key provider groups in a wide geography across FL.

Support and direct involvement with issue resolution and negotiating contracts, focusing on favorable terms and compliance with organizational standards, strategy, and regulatory requirements.
With support from your leader, utilizes data and analytics of provider financial issues and competitor strategies to inform business decisions.
Adhere to defined metrics and SLAs including but not limited to provider outreach and contract completion.
Build and maintain positive relationships with healthcare providers and ensure timely and professional resolution of provider issues to ensure network stability and quality.
Collaborate with the provider services team regarding the servicing, education and communication to our provider network.
Support provider onboarding, training, and resource distribution.
Collaborate with internal teams such as Claims, Credentialing, and Contracting to resolve routine provider issues.
Participate in process improvement initiatives to optimize workflows and enhance provider experience.

You will report into the Senior Director, Network Contracting & Services.

Responsibilities

~1 min read

→Support and direct involvement with issue resolution and negotiating contracts, focusing on favorable terms and compliance with organizational standards, strategy, and regulatory requirements.
→With support from your leader, utilizes data and analytics of provider financial issues and competitor strategies to inform business decisions.
→Adhere to defined metrics and SLAs including but not limited to provider outreach and contract completion.
→Build and maintain positive relationships with healthcare providers and ensure timely and professional resolution of provider issues to ensure network stability and quality.
→Collaborate with the provider services team regarding the servicing, education and communication to our provider network.
→Support provider onboarding, training, and resource distribution.
→Collaborate with internal teams such as Claims, Credentialing, and Contracting to resolve routine provider issues.
→Participate in process improvement initiatives to optimize workflows and enhance provider experience.

Requirements

~1 min read

2+ years of experience in provider network operations or contracting or provider services
1+ years of experience in Health Insurance (Individual and/or Medicare Advantage) and/or Healthcare industry
1+ years experience navigating and organizing large data sets such as claim files and provider rosters

Nice to Have

~2 min read

Associates degree or equivalent professional working experience.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

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