Sr. Specialist, Credentialing

Hi, we're Oscar. We're hiring a Sr. Specialist, Credentialing 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 solve complex issues or concerns impacting our provider credentialing process. You will act as a subject matter expert for credentialing. You will work cross functionally between teams across Oscar. You will track and trend provider and facility credentialing issues and partner with stakeholders to resolve escalated issues. You will support process improvement processes for the credentialing team.

You will report into the Manager, Provider Credentialing.

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

Pay Transparency: The hourly pay for this role is: $24.00/hr. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities

• Support, manage, or escalate complex issues that are not solved using conventional workflows.
• Effectively manage internal or external escalated transactions and communicate with appropriate parties for effective resolution in adherence to SLAs
• Act as a point person for stakeholders in other areas of the business to improve feedback loops and trend facility and provider credentialing issues
• Manage queue work and and assigned caseload through efficient dashboard management
• Collaborate daily with production and credentialing leaders on systemic issues and communicate blockers to care and satisfaction
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements

• 1+ years of credentialing experience for facilities, adhering to NCQA standards
• 2+ years previous work experience in a fast-paced volume-based environment
• 2+ years strong quantitative or analytical skills focused on proactively identifying or solving problems
• Experience working in health insurance

Bonus points

• Bachelor's Degree
• High school diploma or GED
• 1+ years of credentialing experience for practitioners, adhering to NCQA standards
• 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
• Strong verbal and written communications, and interpersonal interactions

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 ([email protected]) 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 Privacy Policy.