Associate, National Ancillary Contracting
Oscar Health
Hi, we're Oscar. We're hiring an Associate to join our National Ancillary 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:
The Associate is crucial to the Specialty Contracting team. This role focuses on recruitment and account management for National Ancillary providers. This ensures access to quality care and optimizes costs by analyzing provider performance and negotiating reimbursement rates, often involving complex contract terms and regulatory compliance. The Associate also supports network growth and recruiting by directly engaging with prospective providers, assisting with provider issue resolution, supporting cost-saving initiatives, helping design and execute the national ancillary network strategy, and ensuring providers have the necessary information and support to deliver excellent member care.
You will report into the Senior Director, Specialty Contracting.
Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote
Pay Transparency: The base pay for this role is: $87,188 - $114,434 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.
Responsibilities:
- Support Implementation of contracting strategies under the direction of Network Director and/or Manager and in partnership with Market Leaders that align with the company's overall network adequacy, development and cost management objectives.
- Manage and negotiate contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards and regulatory requirements.
- Negotiate Single Case Agreements (SCA's) and Independent Dispute Resolution (IDR) cases.
- Serve as a Subject Matter Expert providing guidance and fostering a collaborative and innovative work environment.
- Supports comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization.
- Utilizes data and analytics of provider financial issues and competitor strategies to support informing negotiation and contracting decisions.
- Facilitates guidance and mentorship of more junior team members by reiterating strategic objectives, providing training and development opportunities, and fostering a collaborative and innovative work environment
- Supports implementation of contracting policies and workflows; supports identifying when effective and efficient contracting processes need improvement Meet defined metrics and SLAs including but not limited to provider outreach and contract completion.
- Collaborate with the provider services team regarding the servicing, education and communication to our provider network.
- Monitor assigned networks to gauge compliance with standards, developing corrective action plans with network contracting and market leadership to remediate deficiencies.
- Compliance with all applicable laws and regulations
- Other duties as assigned
Requirements:
- 3+ years of experience in healthcare client management, healthcare consulting, or provider healthcare contracting, healthcare operations, or a related field
- 2+ years of experience supporting provider network strategy development and negotiating provider contracts
- 1+ years experience running financial analyses on a markets or product lines, and working cross-functionally to support driving improvement opportunities
- 1+ years experience navigating and organizing large data sets such as claim files and provider rosters
Bonus points:
- Associate's degree or equivalent professional working experience.
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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. 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.
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