Manager, Credentialing Operations

Remote

Oscar logo
Oscar
Apply now Apply later

Posted 1 week ago

Hi, we're Oscar. We’re hiring an Operations Manager to join our Clinical Operations team in our New York office. 

Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, transparent, and human. We need your help to do so.

About the role:

As an Operations Manager leading our Provider Credentialing team at Oscar, you will support and lead Oscar’s credentialing function. Credentialing is the process by which we review the qualifications of the providers we partner with to ensure they have all certifications to deliver safe, quality care to our members. It is a critical part of our business requiring complex data exchanges and a high degree of regulatory sensitivity. In this capacity, you will be responsible for building outstanding processes, improving quality for core operational tasks and managing partners across all departments, such as Network, Data, Sales, Product, Engineering, Finance, Legal and Compliance. Your team will develop foundational processes for our scaling operations, provide analytical support and summarize the complexity of our data and operations into clear explanations. You will also run our credentialing regulatory activities, including auditing our partners and reporting to regulators and Oscar leadership on any risks in our network. This role will combine ongoing operations management with long-term strategic thinking to improve our Credentialing system through better policies, tools, and data management. The outcomes your team provides will propel Oscar’s priorities and shape how Oscar operates.

You will report into the Associate Director, Clinical Operations. 

Responsibilities:

  • Surface data, process, and technology issues through proactive identification, measurement, and monitoring of our operations
  • Partner with our product/engineering team to develop and implement improvements to existing workflows 
  • Become a subject matter expert in the regulatory and operational requirements of credentialing and ensure our operations are in compliance
  • Continually refine operational processes for Credentialing to ensure compliance and scalability
  • Collaborate with Oscar’s regulatory teams to refine our credentialing standards and policies
  • Manage and maintain relationships with relevant Oscar business leads as a representative of the Credentialing operations team
  • Become the go-to individual at the company for Credentialing operations
  • Support your team and leadership by driving decisions and implementation on an ongoing basis

Requirements:

  • Advanced understanding of credentialing operations, including knowledge of NCQA and state specific credentialing standards. 
  • 5+ years of operating experience
  • 2+ years building, coaching, developing teams.

Bonus points:

  • Experience in operations management, insurance operations, and/or process improvement
  • CPCS certification
  • Technical aptitude as well as advanced Excel skills and familiarity with database languages (SQL)
  • Experience in a highly collaborative, team-based environment
  • Experience working with a Product and/or Engineering team to leverage technology in creative/novel ways to solve problems
  • Experience in operations management and/or process improvement

Life at Oscar: 

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.

We encourage our members to care for their whole selves, and we encourage our employees to do the same with comprehensive medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, and volunteer opportunities.

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 (accommodations@hioscar.com) to make the need for an accommodation known.

Pay Transparency Policy:

Oscar ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.

Job tags: Coaching Compliance Excel .NET SQL Strategic thinking Subject matter expert