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

Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $72,036 - $85,000 per year. The base pay for this role in all other locations  is: $64,832 - $80,000 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

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