Hi, we're Oscar. We're hiring a Manager, P&L to join our Southeast P&L 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
You will support Individual (ACA) membership growth and management through Oscar’s system, IPA, and provider partnerships. This is done by accomplishing the local network strategy and ensuring providers across our service area have the information and support they need to provide the best member care and accomplish quality outcomes.
You will report to the Regional Vice President - East Region.
This is a remote / work-from-home role. You must reside in one of the following states: Florida, Georgia, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New York, North Carolina, Pennsylvania, Rhode Island, Virginia, or Washington D.C. Note, this list of states is subject to change. #LI-Remote
The base pay for this role in the states of Connecticut, New Jersey, and New York is: $108,00 - $141,750 per year. The base pay for this role in all other locations is: $97,200- $127,575 per year. You are also eligible for employee benefits, and participation in Oscar's unlimited vacation program.
- Be the hospital and physician contract subject matter expert for your geographies and partnerships. Be audible-ready on the network construction, competitive landscape, contract terms (e.g. rates), regulatory mandates and how these aspects impact our overall growth, profitability, and risk your markets.
- Model the best provider relations by taking responsibility for maintaining relationships with provider partners and within the network, including taking a lead role in JOCs.
- Direct and support a team responsible for the servicing, education and communication to our provider network.
- Lead the provider-focused projects to improve quality and financial performance across the network, working with the clinical, quality, pharmacy and healthcare economics teams.
- Manage provider contract strategy, partner program execution, and relationship management for a range of provider partners--from large health systems to small provider groups.
- Guide the development of a network construction plan by analyzing network gaps, research providers to bring in-network, and identify new partnership and market opportunities.
- Monitor provider network access to gauge compliance with standards, implementing corrective actions to improve deficiencies.
- Work with Market P/L team and internal stakeholders to collaboratively Identify important business strategies to help us achieve market goals
- Analyze and assess single-case agreement data to build relevant processes and contracting opportunities to improve in- network use within an assigned market.
- Run the face-off-strategy with identified provider partners, including managing relationships, supporting optimization of the contract / partnership, and serving as the point of escalation for P&L responsibilities (settlements, contract negotiations / renegotiations, PR / operational escalations).
- Build and use existing in-market relationships to grow Oscar’s network and develop favorable relationships with in-network providers.
- A bachelor’s degree or 5 years equivalent work experience
- 3+ years of professional experience in healthcare client management, consulting, or provider healthcare contracting, healthcare finance, performance management, healthcare operations,, or a related field
- Experience in process improvement and workflow design
- Experience running financial analyses on a markets or products, and working cross-functionally to improve opportunities and increase growth and profitability
- ACA marketplace, quality of care, and population health experience
- Prior experience in a consulting or consulting-like role
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..
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.
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 (firstname.lastname@example.org) to make the need for an accommodation known.
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