SVP, Network & Provider Management

New Yorkmid

OperationsOtherManagement

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Quick Summary

Key Responsibilities

Support Market leaders with network tooling, adequacy standards and contracting strategies Develop long-term strategies for network growth and optimization, addressing gaps in service coverage,

Requirements Summary

This position is based in our New York office, requiring a hybrid work schedule with 3 days of in-office

Technical Tools

OperationsOtherManagement

Hi, we're Oscar. We're hiring a SVP, Network & Provider Management to join our Insurance 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

~1 min read

The SVP, Network & Provider Management leader is a key player in Oscar’s mission to enhance the quality and accessibility of care for members while supporting the organization's strategic goals. This role is directly responsible for crafting the overall network strategy, analyzing network adequacy and performance, articulating the engagement and experience standards for Oscar’s providers, providing the necessary tooling to manage network build and maintenance while ensuring compliance with regulatory requirements. This role supports the development and management of Oscar Health Insurance’s provider networks and contract negotiations, and leads a variety of network operations. This leader is key to ensuring Oscar meets its company goals and while providing network insights to support the line of business strategies.

You will report into the EVP. President of Oscar Insurance

Responsibilities

~2 min read

→Support Market leaders with network tooling, adequacy standards and contracting strategies
→Develop long-term strategies for network growth and optimization, addressing gaps in service coverage, and ensuring that the network adapts to changing healthcare trends and member needs.
→Utilize market trends and data to inform network strategy and identify opportunities for growth and improvement
→Ensure the development and maintenance of a comprehensive provider network, including hospitals, physicians, and ancillary providers.
→Demonstrating shared leadership in the overall insurance business by balancing the need to provide a broad network of services with controlling costs for both the company and policyholders through strong unit cost guidelines and contracting parameters.
→Monitor network adequacy and compliance with regulatory requirements.
→Monitor and evaluate network performance, addressing gaps and opportunities for improvement.
→Provide central management of contract inventory, renewals and amendments, ensuring all agreements are up-to-date and compliant with organizational policies and regulations.
→Provide guidance and support in contract negotiations and network management.
→Lead a variety of provider operations such as credentialing, contract configuration and provider data management
→Ensure a cohesive provider experience through leadership of provider success, provider communications, and provider marketing. This includes partnering with Provider Relations and other operational areas such as Claims.
→Collaborate with other departments, such as sales, marketing, and operations, to align network strategy with organizational goals.
→Partner with technology to develop necessary tools and processes to manage Oscar’s networks.
→Compliance with all applicable laws and regulations
→Other duties as assigned

Requirements

~1 min read

20+ years experience in provider contracting, network management, or a related field within the healthcare or health insurance industry.
10+ years experience leading in matrixed organizations
10+ years experience building systems and processes to support provider network operations, from the ground up

Nice to Have

~2 min read

Experience partnering with technology teams to optimize and evolve operational programs
Demonstrated success in growing provider networks

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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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