Associate, National Provider ContractingActive$97K–$127K
The opportunity
Hi, we're Oscar. We're hiring a Provider Contracting Associate to join our National Contracting team.
What you'll do
Support the development and execution of national contracting strategies for: large ancillary providers and/or health systems, aligned with network adequacy, access, quality, and cost-management objectives.
Manage an assigned portfolio across the full contracting lifecycle, including: prospecting, evaluation, negotiation, implementation, performance management, renewal, and termination.
Prepare for and negotiate complex provider agreements, including: reimbursement, operational, data-sharing, performance, and compliance terms, within established authority and escalation guidelines.
Coordinate contract implementation with Legal, Finance, Provider Operations,: Claims, Credentialing, Configuration, Compliance, and Market teams to ensure accurate and timely operational readiness.
Build and maintain productive relationships with provider contracting and: operational leaders; lead routine business reviews, resolve escalated issues, and coordinate corrective action plans.
Analyze claims, utilization, reimbursement, provider roster, market, and: competitive data to develop negotiation positions, quantify financial impact, and identify performance improvement opportunities.
What they're looking for
- Monitor assigned networks and provider performance for access, adequacy,: quality, cost, and contractual compliance; escalate risks and support remediation with Network and Market leadership.
- Maintain accurate contracting pipeline, status, documentation, and provider: data; meet defined service-level agreements and performance metrics for outreach, negotiations, and contract completion.
- Compliance with all applicable laws and regulations
- Other duties as assigned
