Director – Network Contracting & Services

Director – Network Contracting & Services

Requirements

• 10+ years of experience in healthcare provider contracting, network development, or related areas.
• 5+ years experience negotiating complex contracts with hospitals, physician groups, and other healthcare providers.
• 4+ years of leadership or managerial experience in a healthcare setting.

Responsibilities

• Develop and implement contracting strategies in partnership with Market Leaders that align with the company’s overall network development and cost management objectives.
• Lead and mentor the provider contracting team, setting clear goals and expectations.
• Collaborate with the Network Monitoring & Performance team to identify network gaps and develop strategies to expand provider relationships and access to care.
• If necessary, be able to source and identify OON provider targets that align with Oscars overall Market strategy.
• Lead contract negotiations with hospitals, physicians, ancillary service providers, and other healthcare entities.
• Develop and execute contracting agreements that drive financial performance, ensure access to quality care, and support cost control efforts.
• Ensure timely resolution of provider issues related to contract terms, reimbursement, and network participation.
• Ensure all provider agreements comply with relevant federal, state, and local regulations.
• Act as a primary point of contact between the organization and healthcare providers for contracting-related activities.
• Build and maintain strong working relationships with providers to foster collaboration and network stability.
• Compliance with all applicable laws and regulations
• Other duties as assigned.

Preferred Qualifications

• Strong understanding of healthcare delivery systems, reimbursement models, and managed care principles.