Oscar Health
VP, Network Management - Texas, Central, West Markets
About this role
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 Pay Transparency: The base pay for this role is: $240,120 - $315,157 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, company equity grants and annual performance bonuses.
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: