Senior Specialist, Network Contracting
Senior Specialist, Network Contracting
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$ 76800 - 100800
1 Vacancy
Job Description
Hi were Oscar. Were hiring a Senior Specialist Network Contracting to join our Provider Network team.
Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family.
About the role
The Senior Specialist Network Contracting within the Independent Dispute Resolution (IDR) team intakes processing and negotiating post service single case agreements in the open negotiation period ensuring claims are handled fairly often under regulations like the No Surprises Act. This involves research strategy communication and coordination of all IDRrelated matters. The Senior Specialist may also play a role in recruiting new providers to the network assisting with resolution of provider issues and supporting costsaving initiatives.
You will report to the Senior Director Specialty Contracting. You will be Management Level 3.
Work Location:
Oscar is a blended work culture where everyone regardless of work type or location feels connected to their teammates our culture and our mission.
If you live within commutable distance to our New York City office (in Hudson Square) our Tempe office (off the 101 at University Dr) or our Los Angeles office (in Marina Del Rey) you will be expected to come into the office at least two days each week. Otherwise this is a remote / workfromhome role.
You must reside in one of the following states: Alabama Arizona Arkansas California Colorado Connecticut Florida Georgia Illinois Indiana Iowa Kansas Kentucky Maine Maryland Massachusetts Michigan Minnesota Missouri Nevada New Hampshire New Jersey New Mexico New York North Carolina Ohio Oregon Pennsylvania Rhode Island South Carolina Tennessee Texas Utah Vermont Virginia Washington or Washington D.C. Note this list of states is subject to change. #LIRemote
Pay Transparency:
The base pay for this role in the states of California Connecticut New Jersey New York and Washington is: $76800 $100800 per year. The base pay for this role in all other locations is: $$77760 $90720 per year. You are also eligible for employee benefitsmonthly vacation accrual at a rate of 15 days per year and annual performance bonus.
Responsibilities
- Negotiate with OutOfNetwork (OON) providers/facilities to achieve favorable single case rates and avoid mediation/arbitration when possible.
- Support and direct involvement with negotiating contracts with assigned healthcare providers focusing on favorable terms and compliance with organizational standards strategy and regulatory requirements.
- Conduct comprehensive reviews and analyses of assigned provider contracts identifying areas for improvement and optimization.
- With support from your leader utilizes data and analytics of provider financial issues and competitor strategies to inform negotiation and contracting decisions.
- Support implementation of contracting policies and workflows; monitors and ensure efficient contracting processes are in place.
- With input and support from their leader monitor and analyze key metrics for network performance cost and provider satisfaction and provide reports to leadership for assigned provider accounts.
- Ensure and professional resolution of provider issues Build and with healthcare providers to ensure network stability and quality.
- Help track and analyze key performance indicators (KPIs) to monitor provider satisfaction and operational efficiency.
- 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 plans to optimize workflows and enhance provider experience.
- Compliance with all applicable laws and regulations
- Other duties as assigned.
Qualifications
- 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.
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 discriminationfree hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. Were 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. Fulltime 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.
Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications without regard to applicants disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known.
Artificial Intelligence (AI) Guidelines: Please see our AI Guidelines for the acceptable use of artificial intelligence during the interview process at Oscar.
California Residents: For information about our collection use and disclosure of applicants personal information as well as applicants rights over their personal information please see our Notice to Job Applicants.
Required Experience:
Senior IC
Employment Type
Contract
