Network Contracting Operations Manager Job at Oscar Health
Hi, we're Oscar. We're hiring a Network Contracting Operations Manager to join our Northeast P&L 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 ourselves—one that behaves like a doctor in the family.
About the role
Network adequacy and contracting is critical to ensuring members have access to high quality care, and that our products are regulatory compliant to be sold in the market place. This role will be responsible for building, managing and evolving the core processes for the organization responsible for contracting with the providers. This includes, translating the definition of success for the Network Specialists into outcome and performance metrics, identifying and designing the processes needed to drive those metrics, collaboratively building the right tools for the team to use, monitoring the processes and problem solving process issues, continuously evolving the processes and tools so that the teams and networks are achieving their results, and training the teams as needed.
You will report to the Director, North East Market P&L. This is a remote / work-from-home role. You must reside in one of the following states: Arizona, California, Connecticut, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote
The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $108,000 - $141,750 per year. The base pay for this role in all other locations is: $97,200-$127,575 per year. You are also eligible for employee benefits, and annual performance bonuses.
Responsibilities
- Build a strong understanding of the Oscar's contracting workflows and the key terms and rate structures of our provider agreements.
- Support the design and oversight of all steps of the contracting workflow for markets and leads as assigned (for example: market research to identify leads, lead outreach, contract negotiation, roster collection, contract page configuration, credentialing, single case agreement negotiations)
- Ensure signed contracts successfully go through the full process
- Support management in the ongoing evolution of the org structure and team processes
- Support management in the identification of implementation of performance metrics and performance incentives for the team
- Support the identification of training needs for the team, and coordinate training sessions of the team as needed
- Central escalation point / triage point for process questions (e.g. how do you contract a home health center, what type of rate sheet does anesthesia use, how to use Docusign, which template to use)
- Manage team ticket assignments and work with market leadership to identify capacity and redistribute leads/projects as needed
- Support communication across stakeholders - PR, Claims etc. - as issues arise with providers
- Drive changes in Oscar's contracting processes based on broader cross-functional process changes for SCA
Qualifications
- Bachelors or associate degree in Business, Finance, Health Care Administration or at least 4+ years experience in payer or provider healthcare contracting, healthcare finance, performance management, healthcare operations, consulting, or a related field
- Familiarity with Word, Excel, and Powerpoint (or Google suite equivalent)
- Experience in process improvement / process redesign
- Experience negotiating contracts in medical insurance
Bonus Points
- Experience in a customer support/customer service role
- Experience negotiating contracts, specifically with ancillaries, facilities, specialty providers, and physician groups
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, paid holidays, paid vacation and 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 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.
To protect the health and safety of our employees, we require any employee conducting in-person work* to be fully vaccinated against COVID-19 by their start date. If you are unable to be vaccinated due to medical or protected religious reasons, please reach out to our Benefits team at accommodations@hioscar.com to submit an accommodations request.
- Note: In-person work includes: employees required to work from our offices, employees conducting sales work in the field and employees conducting at-home or in-person visits with members.
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