VP, Network Management - Texas, Central, West Markets

Hi, we're Oscar. We're hiring a VP, Network Management to join our Network Team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless 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 Vice President of Network Management is responsible for the contracting strategy, development, and management of a high-performing provider network for a defined geographic area within Oscar’s footprint. This role oversees the strategic planning and execution of contracts that ensure a robust, cost-effective, and comprehensive provider network that meets the needs of our members, including provider account management & service.

This leader collaborates with internal and external stakeholders to improve network performance, enhance provider relationships, ensure regulatory compliance, and drive high-quality, cost-effective care delivery.

You will report into the SVP, Network & Provider Management.

Work Location:

This is a remote position, open to candidates who reside in: Arizona, California, Colorado, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Mexico, Ohio, Oregon, South Dakota, Texas, Utah, Washington or Wisconsin. A hybrid work schedule, with 3 days of in-office work per week, may be required depending on your metro area. #LI-Remote

Responsibilities:

• Lead the execution of short- and long-term strategic plans for provider network growth, alignment, and optimization.
• Develop a strategy to enhance network adequacy, access, and member experience across multiple markets.
• Oversee execution of provider contracting strategy, including value-based and fee-for-service contracting models, to improve care quality and control costs.
• Build and maintain strong relationships with key health system leaders, hospital executives, and other network providers.
• Negotiate and manage high-value, complex contracts to support cost containment and quality initiatives.
• Monitor and analyze network performance metrics, including cost, utilization, quality, and member satisfaction.
• Execute initiatives to enhance provider network performance, drive efficiencies, and improve member access to care.
• Ensure that the provider network meets all state, federal, and accreditation standards for access, adequacy, and service.
• Stay abreast of regulatory changes and industry best practices to ensure compliance and minimize risk.
• Work with compliance and legal teams to address and mitigate risks related to provider contracting and network performance.
• Lead, mentor, and develop a high-performing network management team to drive results and support professional growth.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• 15+ years of progressive experience in network management, provider relations, or health plan operations
• 10+ years of leadership experience
• 10+ years experience in provider contracting, negotiations, and building provider relationships.
• 8+ years managing large provider networks within a health insurance or managed care setting.
• This is an authentic Oscar Health job opportunity.
• 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.

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.