Associate, Credentialing Operations at Oscar Health

Boston, Massachusetts, United States -

Full Time

Start Date

Immediate

Expiry Date

28 Jan, 26

Salary

110565.0

Posted On

30 Oct, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Credentialing, Data Analysis, Quality Auditing, Compliance, Cross-Functional Collaboration, Problem Solving, Communication, Interpersonal Skills, Excel, Google Sheets, Health Insurance, Process Improvement, Primary Source Verification, Data Integrity, Accreditation, Operational Efficiency

Industry

Insurance

Description

Hi, we're Oscar. We're hiring an Associate to join our Credentialing Operations team. 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 ourselves—one 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 & timely delivery of required reporting. You will report to the Manager, Provider Credentialing. Work Location: This is a remote position, open to candidates who reside in: Boston, Massachusetts. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $84,240 - $110,565 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 within a health insurance company (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 This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. 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. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. 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. California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Notice to Job Applicants.

Responsibilities

The Associate is responsible for supporting and enhancing the quality of credentialing functions and managing operational data to optimize business processes. They will collaborate with various departments to identify improvement opportunities and ensure accurate reporting.