Associate, National Provider Contracting

Hi were Oscar. Were hiring a Provider Contracting Associate to join our National 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 ourselvesone that behaves like a doctor in the family.

About the role:

The Associate National Contracting manages an assigned portfolio of large national ancillary providers and/or multi-state health systems across the contracting lifecyclefrom market assessment and recruitment through negotiation implementation performance management renewal and escalation. Working with Network leadership and cross-functional partners this role translates network access and affordability goals into executable contract strategies; uses financial claims and provider data to inform negotiations; and maintains durable provider relationships. The Associate helps ensure contracts are operationally sound compliant and positioned to deliver high-quality cost-effective member care across markets.

You will report into the Senior Director Specialty Contracting.

Work Location: This is a remote position based in the field open to candidates who reside: Alabama Arizona California Florida Illinois Iowa Kansas Michigan Mississippi Missouri Nebraska New York North Carolina Ohio and Texas. 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. #LI-Remote

Pay Transparency: Pay Transparency:The base pay for this role in the states of California Connecticut New Jersey New York and Washington is: $96876 - $127149 per year. The base pay for this role in all other locations is: $87188- $114434 per year. You are also eligible for employee benefits participation in Oscars unlimited vacation program and annual performance bonuses.

Responsibilities:

• Support the development and execution of national contracting strategies for large ancillary providers and/or health systems aligned with network adequacy access quality and cost-management objectives.
• Manage an assigned portfolio across the full contracting lifecycle including prospecting evaluation negotiation implementation performance management renewal and termination.
• Prepare for and negotiate complex provider agreements including reimbursement operational data-sharing performance and compliance terms within established authority and escalation guidelines.
• Coordinate contract implementation with Legal Finance Provider Operations Claims Credentialing Configuration Compliance and Market teams to ensure accurate and timely operational readiness.
• Build and maintain productive relationships with provider contracting and operational leaders; lead routine business reviews resolve escalated issues and coordinate corrective action plans.
• Analyze claims utilization reimbursement provider roster market and competitive data to develop negotiation positions quantify financial impact and identify performance improvement opportunities.
• Monitor assigned networks and provider performance for access adequacy quality cost and contractual compliance; escalate risks and support remediation with Network and Market leadership.
• Maintain accurate contracting pipeline status documentation and provider data; meet defined service-level agreements and performance metrics for outreach negotiations and contract completion.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• 3 years of experience in provider contracting provider network management healthcare consulting healthcare operations or a related field.
• 2 years of experience supporting provider network strategy and negotiating provider agreements.
• Demonstrated experience managing complex multi-stakeholder contracting work from analysis and negotiation through implementation and ongoing performance management.
• Experience building effective relationships with provider contracting and operational leaders and communicating recommendations to internal stakeholders.
• 1 years of experience performing financial analysis for healthcare markets provider contracts or product lines and translating findings into negotiation or improvement opportunities.
• 1 years of experience working with large data sets such as claims utilization fee schedules contract inventories and provider rosters.

Bonus points:

• Bachelors degree in business healthcare administration finance economics or a related field or equivalent professional experience.
• Experience contracting with national ancillary provider organizations multi-state provider groups or large health systems.
• Working knowledge of provider reimbursement methodologies contract language claims data network adequacy and provider operations.

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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. 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. 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.

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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.

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