Senior Analyst, Credentialing Operations

Hi, we're Oscar. We're hiring a Senior Analyst, Credentialing Operations to join our Provider Operations 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:

You will work to support and enhance the quality of the credentialing functions. Positively impact provider experiences and member outcomes by ensuring provider data is maintained consistently and managing critical/complex data escalations to resolution. Communicate with providers and work collaboratively with other teams to provide efficient and thorough resolution by providing world class service.

You will report into the Manager, Provider Credentialing.

Work Location: This is a remote position, open to candidates who reside in: Florida. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.

Pay Transparency: The base pay for this role is: $61,851 - $81,180 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

Responsibilities:

• Maintain existing and incoming provider information to ensure accuracy and quality of the network by supporting complex non-standard provider information processing needs.


• Assist with administrative process improvements to enhance productivity


• Provide ongoing training and support to Credentialing Operations team members


• Conduct Primary Source Verification (PSV) and validate practitioner and facility credentials in compliance with NCQA standards


• Support employees on the team of all levels through escalation research and resolution


• Effectively communicate findings and resolutions with providers and internal departments inclusive of collaboration with cross-functional stakeholders


• Manage queue work and assigned caseload through effective dashboard management while ensuring integrity of information entered into company and external systems. Support junior employees in queue management and prioritization.


• Compliance with all applicable laws and regulations


• Other duties as assigned

Requirements:

• 2+ years of credentialing experience, both individual practitioner and facility, adhering to NCQA standards


• 2+ years of intermediate Excel/Google Sheet proficiency


• 2+ years of assessing and comprehending end to end process impact


• 2+ years experience resolving credentialing problems


• 2+ years of inventory management queue experience

Bonus points:

• 2+ years of intermediate proficiency in SQL, BigQuery or similar database language experience


• Background in health insurance


• Proficiency with non Microsoft business platforms


• Proficiency in using a credentialing or provider data repository


• Primary Source Verification


• Experience with healthcare data such as provider data