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Oscar

Senior Specialist, Network Contracting

RemoteUnited States, Colombia, Cuba +2 more only
Published
Role
Operations
Experience
Senior
Employment
Full-time
$71.5k–$93.9k/yr
Check eligibility

Open to US, CO, CU, GE, UY only. Set where you work from to check your eligibility.

No BS summary

Senior Specialist responsible for negotiating and managing Single Case Agreements (SCAs) with healthcare providers. The role requires experience in provider network operations or contracting and health insurance, with a focus on data analysis and regulatory compliance.

What you'll do

  • Support and direct involvement with negotiating contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards, strategy, and regulatory requirements.
  • Conducts 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.
  • Supports implementation of contracting policies and workflows; monitors and ensures effective and 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 timely and professional resolution of provider issues
  • Build and maintain positive relationships with healthcare providers to ensure network stability and quality.
  • Assist in tracking and analyzing 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 initiatives to optimize workflows and enhance provider experience.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

What they require

  • 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
  • Bonus points: Associate’s degree or equivalent professional working experience.

Benefits

  • employee benefits
  • participation in Oscar's unlimited vacation program
  • annual performance bonuses
  • medical, dental, and vision benefits
  • 11 paid holidays
  • paid sick time
  • paid parental leave
  • 401(k) plan participation
  • life and disability insurance
  • paid wellness time and reimbursements

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members.

🇺🇸 United StatesHealthcareMid-size
$71.5k–$93.9k/yr