SVP, Network & Provider Management at Oscar · Lumi · Lumi

Responsibilities

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.
Work Location: This position is based in our New York office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid
Pay Transparency: The base pay for this role is: $319,608 - $419,107 per year. You are also eligible for employee benefits, participation in Oscar s unlimited vacation program, company equity grants and annual performance bonuses.
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.

Qualification

At OscarPay TransparencyArtificial Intelligence (AI)Reasonable AccommodationCalifornia Residents

Required

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

Preferred

Experience partnering with technology teams to optimize and evolve operational programs
Demonstrated success in growing provider networks
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.
Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.
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.
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 Privacy Policy.

SVP, Network & Provider Management

Responsibilities

Qualification

Required

Preferred

Benefits

Company

Oscar

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