Senior Analyst, Credentialing Operations

<p>Hi, we're Oscar. We're hiring a Senior Analyst, Credentialing Operations to join our Provider Operations team.</p> <p>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.</p> <p><strong>About the role:</strong></p> <p>You will work to support and enhance the quality of the credentialing functions. Positively impact provider experiences and member outcomes by ensuring provider data is maintained consistently and managing critical/complex data escalations to resolution. Communicate with providers and work collaboratively with other teams to provide efficient and thorough resolution by providing world class service.</p> <p>You will report into the Manager, Provider Credentialing.</p> <p><strong>Work Location: </strong>This is a remote position, open to candidates who reside in: Florida<strong>.</strong> While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote</p> <p><strong>Pay Transparency: </strong>The base pay for this role is: $61,851 - $81,180 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.</p> <p><strong>Responsibilities:</strong></p> <ul> <li>Maintain existing and incoming provider information to ensure accuracy and quality of the network by supporting complex non-standard provider information processing needs.</li> <li>Assist with administrative process improvements to enhance productivity</li> <li>Provide ongoing training and support to Credentialing Operations team members</li> <li>Conduct Primary Source Verification (PSV) and validate practitioner and facility credentials in compliance with NCQA standards</li> <li>Support employees on the team of all levels through escalation research and resolution</li> <li>Effectively communicate findings and resolutions with providers and internal departments inclusive of collaboration with cross-functional stakeholders</li> <li>Manage queue work and assigned caseload through effective dashboard management while ensuring integrity of information entered into company and external systems. Support junior employees in queue management and prioritization.</li> <li>Compliance with all applicable laws and regulations</li> <li>Other duties as assigned</li> </ul> <p><strong>Requirements:</strong></p> <ul> <li>2+ years of credentialing experience, both individual practitioner and facility, adhering to NCQA standards</li> <li>2+ years of intermediate Excel/Google Sheet proficiency</li> <li>2+ years of assessing and comprehending end to end process impact</li> <li>2+ years experience resolving credentialing problems</li> <li>2+ years of inventory management queue experience</li> </ul> <p><strong>Bonus points:</strong></p> <ul> <li>2+ years of intermediate proficiency in SQL, BigQuery or similar database language experience</li> <li>Background in health insurance</li> <li>Proficiency with non Microsoft business platforms</li> <li>Proficiency in using a credentialing or provider data repository</li> <li>Primary Source Verification</li> <li>Experience with healthcare data such as provider data</li> </ul><div class="content-conclusion"><p><span style="font-weight: 400;">This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud</span><a href="http://hioscar.com/careers/recruitment-fraud-alert"><span style="font-weight: 400;"> </span><span style="font-weight: 400;">here</span></a><span style="font-weight: 400;">. </span></p> <p><span style="font-weight: 400;">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 th ... (truncated, view full listing at source)