[Hiring] Associate Manager, Credentialing Operations @Oscar Health

Role Description

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.

Pay Transparency:

• The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $72,036 - $94,547 per year.
• The base pay for this role in all other locations is: $64,832 - $85,092 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.

Qualifications

• 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.

Requirements

• 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.

Benefits

• Medical, dental, and vision benefits.
• 11 paid holidays.
• Paid sick time.
• Paid parental leave.
• 401(k) plan participation.
• Life and disability insurance.
• Paid wellness time and reimbursements.