Remote Position

[Remote] Associate Manager, Credentialing Operations

๐ŸŒ Remote ยท United States ๐Ÿ’ผ Full-time

Note: The job is a remote job and is open to candidates in USA. Oscar Health is hiring an Associate Manager, Credentialing Operations to lead a team responsible for accurate and timely provider credentialing and re-credentialing. The role oversees production, quality, service levels, compliance, and escalations while using performance data and cross-functional partnerships to improve workflows, mitigate risk, strengthen provider experience, and maintain network readiness.

Responsibilities

  • Evaluates overall departmental performance by creating, gathering, analyzing and interpreting data and metrics as well as assisting in development of departmental metrics and implementation of mitigation strategies
  • Lead the day-to-day credentialing operation, including workload planning, queue management, service-level performance, quality, and issue resolution
  • Collaboratively works with all relevant internal and external stakeholder groups to formulate proactive implementation, communications, and program strategies for successful change management and risk mitigation initiatives
  • Conduct root-cause analysis on systemic issues and construct action plans to address
  • Maintains, analyzes, and communicates reporting on assigned team KPIs. Track monthly and quarterly to meet departmental objectives
  • Hire and manage a team of Oscar colleagues with direct responsibility for performance management, their growth and development, and associated HR administrative tasks
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Skills

  • 3+ years of direct people management experience
  • 2+ years of experience in provider credentialing, re-credentialing, provider enrollment, or a closely related function
  • 3+ years of healthcare operations experience supporting high-volume production teams
  • 1+ year experience using data to drive decision making and continuous improvement
  • Strong proficiency navigating Excel/Google Sheets, JIRA, and/or SQL
  • Working knowledge of credentialing standards and requirements, including NCQA, CMS, state, and delegated-credentialing requirements
  • Experience supporting process improvement initiatives cross-functionally
  • Bachelor's Degree
  • Experience leading credentialing operations for a health plan, health system, provider organization, or credentials verification organization
  • Prior healthcare or insurance-related experience

Benefits

  • Fully remote position, open to candidates residing in the U.S., excluding Alaska, Delaware, Hawaii, Louisiana, Montana, North Dakota, Oklahoma, West Virginia, Wyoming, and U.S. Territories; daily work is completed from your home office, with occasional travel required for team meetings and company events.
  • Participation in Oscar's unlimited vacation program
  • Annual performance bonuses
  • Medical, dental, and vision benefits
  • 11 paid holidays
  • Paid sick time
  • Paid parental leave
  • 401(k) plan participation
  • Life and disability insurance
  • Paid wellness time and reimbursements

Company Overview

  • Oscar is a health insurance company that offers individual and family plans, medicare advantages, and small group products. It was founded in 2012, and is headquartered in New York, New York, USA, with a workforce of 1001-5000 employees. Its website is http://www.hioscar.com.
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