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Senior Network Specialist

Oscar Health

United States

Remote

USD 69,000 - 91,000

Full time

2 days ago

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Job summary

Oscar Health is seeking a Senior Network Specialist to manage provider contracts and ensure access to quality care. The role involves negotiation, data analysis, and collaboration with internal teams to enhance provider satisfaction. This remote position requires residence in Tennessee or Georgia.

Benefits

Employee benefits

Monthly vacation accrual

Annual performance bonus

Qualifications

2+ years in provider network operations or contracting.
1+ years in health insurance or healthcare industry.
Experience with large data sets like claim files.

Responsibilities

Negotiate contracts with healthcare providers.
Analyze provider performance and reimbursement rates.
Support provider onboarding and issue resolution.

Skills

Provider relationship management

Contract negotiation

Data analysis

Compliance knowledge

Education

Associate's degree or equivalent

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Join to apply for the Senior Network Specialist role at Oscar Health

Hi, we're Oscar. We're hiring a Senior Network Specialist to join our Provider Network team.

About The Role

The Senior Network Specialist is responsible for negotiating and managing contracts with healthcare providers (hospital/health system and individual) to build and maintain a robust network in assigned market/region; while also ensuring access to quality care and optimizing costs by analyzing provider performance and reimbursement rates, often involving complex contract terms and compliance with regulatory guidelines. The Senior Specialist also plays a role in recruiting new providers to the network, assisting with resolution of provider issues, and supporting cost-saving initiatives.

You will report into the Manager, Network Contracting.

Work Location:

This is a remote position. You must reside in Tennessee or Georgia.

Pay Transparency

The base pay for this role is: $69,120.00- $90,720.00 per year. You are also eligible for employee benefits, monthly vacation accrual at a rate of 10 days per year. And an annual performance bonus.

Responsibilities

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 and professional resolution of provider issues And build relationships with healthcare providers to ensure network stability and quality.
Help track and analyze measurements 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 programs to increase workflows and enhance provider experience.
Compliance with all applicable laws and regulations.
Other responsibilities as assigned.
Up to 20% travel required.

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

Bonus

Associate's degree or equivalent professional working experience.

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, 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 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.

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.

Seniority level

Seniority level
Mid-Senior level

Employment type

Employment type
Full-time

Job function

Job function
Information Technology
Industries
Insurance

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