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