VP, Network Management

About the role

Oscar Health is seeking a dynamic and experienced Vice President of Network Management to lead our efforts in developing and managing our healthcare provider networks. This role is in ensuring that we deliver high-quality, cost-effective healthcare solutions to our members. The VP will oversee the strategic planning, implementation, and optimization of our network management strategies, collaborating closely with various teams to enhance our service offerings. This position is based in Texas, and the ideal candidate will bring a wealth of experience in healthcare network management, along with a passion for improving patient outcomes.

Key facts

What you'll do

• Develop and execute comprehensive strategies for network management that align with Oscar Health's mission and business objectives.
• Lead the negotiation and contracting processes with healthcare providers, ensuring favorable terms that benefit both the organization and our members.
• Analyze and assess the performance of the provider network, utilizing data-driven insights to identify areas for improvement and implement necessary changes.
• Collaborate with clinical teams to ensure that network providers meet quality standards and deliver exceptional care to our members.
• Establish and maintain strong relationships with key stakeholders, including providers, payers, and regulatory bodies, to foster collaboration and support network growth.
• Monitor industry trends and regulatory changes to proactively adapt network strategies and maintain compliance.
• Oversee the development of innovative programs and initiatives aimed at enhancing member engagement and satisfaction within the network.
• Lead a team of network management professionals, providing mentorship, guidance, and support to foster a high-performing culture.
• Prepare and present reports to senior leadership on network performance, challenges, and opportunities for growth.
• Drive initiatives to expand the network geographically and demographically, ensuring access to care for diverse populations.
• Implement technology solutions that streamline network management processes and enhance data analytics capabilities.
• Foster a culture of continuous improvement within the network management team, encouraging innovative thinking and problem-solving.

Requirements

• A minimum of 10 years of experience in healthcare network management, with a proven track record of success in a leadership role.
• Strong understanding of healthcare regulations, reimbursement models, and provider contracting processes.
• Excellent analytical skills, with the ability to interpret complex data and make informed decisions.
• Demonstrated experience in negotiating contracts and managing provider relationships effectively.
• Exceptional communication and interpersonal skills, with the ability to engage and influence stakeholders at all levels.
• A strategic thinker with the ability to develop and implement long-term plans that drive organizational success.
• Experience in managing and developing high-performing teams, with a focus on employee engagement and professional growth.
• Proficiency in using data analytics tools and healthcare management software.
• A Master's degree in healthcare administration, business administration, or a related field is preferred.

Nice to have

• Previous experience in a managed care organization or health insurance company.
• Familiarity with value-based care models and population health management strategies.
• Experience working with diverse populations and understanding the unique healthcare needs of various communities.
• Knowledge of emerging healthcare technologies and their application in network management.
• Certification from a relevant professional organization, such as the National Association of Managed Care Physicians (NAMCP) or the American Association of Health Plans (AAHP).

Skills & tools

• Strong leadership and team management capabilities.
• Proficient in data analysis and reporting tools, such as SQL, Tableau, or similar platforms.
• Excellent negotiation and conflict resolution skills.
• Ability to work collaboratively in a fast-paced, dynamic environment.
• Familiarity with electronic health record (EHR) systems and healthcare IT solutions.
• Strong project management skills, with the ability to manage multiple initiatives simultaneously.

Practical notes

• The position is based in Texas, and candidates should be prepared for occasional travel as needed.
• Oscar Health is committed to diversity and inclusion in the workplace and encourages applications from individuals of all backgrounds.
• Interested candidates can apply through the Oscar Health careers page at [Oscar Health Careers](http://www.hioscar.com/careers/8095508?gh_jid=8095508).

This role offers an to make a significant impact on the healthcare landscape while working with a forward-thinking organization dedicated to transforming the way healthcare is delivered. If you are a strategic leader with a passion for network management and a commitment to improving healthcare access and quality, we encourage you to apply.