Operations Manager, Credentialing

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Remote
102K-149K Annually
3-5 Years Experience
Healthtech
The Role

Hi, we're Oscar. We're hiring an Operations Manager, Credentialing to join our Provider 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 Operations Manager, Credentialing role serves as the data product owner primarily for, but not limited to the credentialing and data capabilities. The manager owns stakeholder management, controls, compliance monitoring, and executes strategy and policy development within credentialing. The manager interacts frequently with internal customers and external vendors, partnering across the organization to maintain credentialing process efficiencies.

You will report to the Senior Manager, Operational Insights.

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. 

If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.  

You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $113,600 - $149,100 per year. The base pay for this role in all other locations is: $102,240 - $134,190 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 credentialing-related challenges and develop comprehensive solutions.
  • Ensure the on-going health of the credentialing and data governance capabilities by developing, implementing and enhancing monitoring and reporting.  
  • Oversee the production of required data deliverables and technical & analytical support for credentialing.
  • Support the development of strategies,  processes, policies and reporting that will accelerate and affect the maturity of  the data capability. 
  • Monitor and evaluate data management systems and processes to ensure compliance with regulations and industry standards, including the annual NCQA and CMS credentialing audits.
  • Compliance with all applicable laws and regulations 
  • Other duties as assigned

Qualifications

  • 5+ years of provider and ancillary credentialing experience 
  • 4+ years of experience presenting and delivering messages to senior leadership
  • 1 year Project management expertise
  • Experience working with provider and facility credentialing data

Bonus Points

  • Experience working in operations management or process improvement roles
  • Experience with data management principles, data governance, and data quality assurance
  • 3+ years of experience utilizing SQL (ability to write complex and efficient queries, develop detailed analysis and generate reporting) 
  • 1+ years managerial experience

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.

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.

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 ([email protected]) to make the need for an accommodation known.

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.

The Company
New York, NY
430 Employees
Hybrid Workplace
Year Founded: 2012

What We Do

Healthcare is broken; we're trying to fix it. The Oscar team is focused on utilizing technology, design and data to humanize healthcare. We're a group of technology and healthcare professionals who looked at the current state of the US healthcare system, got frustrated by the horrible consumer experience, and decided to do something big about it.

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