Associate Manager, Credentialing Operations

Hi, we're Oscar. We're hiring an Associate Manager, Credentialing Operations to join our Credentialing 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 Associate Manager, Credentialing Operations leads a team responsible for accurate and timely provider credentialing and re-credentialing. This role oversees production, quality, service levels, and escalations and ensures compliance with applicable regulatory, accreditation, contractual, and internal requirements. The Associate Manager uses performance data and cross-functional partnerships to improve workflows, mitigate risk, strengthen provider experience, and maintain network readiness.

You will report into the Senior Manager, Provider Operations Credentialing.

Work Location:

This position is fully remote and 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. #LI-Remote

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

Requirements:

• 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
• Bonus points: 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
• 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):

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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.

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