Associate, Credentialing Operations
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 ourselvesone that behaves like a doctor in the family.
About the Role
The Associate, Credentialing Operations is responsible for supporting and enhancing the quality of the credentialing functions as well as analyzing, organizing, and managing operational data to optimize business processes and drive efficiency. The Associate works closely with various departments to identify opportunities for improvement and develop strategies to improve data quality, compliance, and support daily operations. The Associate also ensures accurate and timely delivery of required reporting.
You will report to the Manager, Provider Credentialing.
Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. This is a hybrid role in our New York City office. You will work part of the time in the office and part of the time remote / work-from-home.
Pay Transparency: The base pay for this role is: $93,600 - $122,850 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.
Responsibilities
- Collaborate with cross-functional teams to identify provider data-related challenges and develop comprehensive solutions.
- Produce required data deliverables and provide subject matter expert support for Oscar's Operations
- Develop and implement credentialing strategies, policies, and procedures to ensure ongoing data integrity and accuracy.
- Support and conduct internal quality audits of credentialing files, processes, and systems to ensure compliance with regulatory, accreditation, and organizational requirements
- Support delegated credentialing arrangements, including initial and ongoing assessments
- Compliance with all applicable laws and regulations
- Other duties as assigned
Qualifications
- 4+ years of credentialing experience, both individual practitioner and facility, adhering to NCQA standards
- 3+ years professional experience resolving credentialing problems with demonstrated success digging into data to discover root causes and drive solutions
- 2+ years of experience in quality auditing with demonstrated success in identifying and solutioning problem areas
- 2+ years of experience presenting and delivering messages to senior leadership. Strong communication and interpersonal skills to effectively collaborate with cross-functional teams and stakeholders.
- Expert in Excel and/or Google Sheets with 3+ years of experience
Bonus Points
- A bachelor's degree or significant demonstrated success in field
- Experience working with provider and facility data
- Experience working in operations management or process improvement roles.
- Primary Source Verification
- Background in health insurance
- Experience building quality improvement processes