SVP, Network and Provider Management

Hi, we're Oscar. We're hiring a Senior Vice President, Network & Provider Manager to join our Insurance team.

Oscar is the first health insurance company built around a full stack technology platform and a 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

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 to the Chief Insurance Officer.

Work Location: 

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. 

If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.  

You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

Pay Transparency:

The base pay for this role  is: $308,800 - $405,300 per year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program, company equity grants and annual performance bonuses.

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, 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.
• Foster positive relationships with key stakeholders, including healthcare providers, professional organizations, industry and strategic partners, and community partners.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Qualifications

• 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

Bonus Points

• 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.

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 Notice to Job Applicants.