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Oscar Health // health insurance
 
Dallas, Texas, United States    Posted: Saturday, March 13, 2021
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. We're hiring a Manager of Credentialing Operations to join our Clinical Review Team team.

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

About the role:

You will manage strategy & design for Oscar's credentialing function. You will build an outstanding program, improving quality for core operational tasks, & working with partners across multiple departments. You will combine ongoing operations management with long-term strategic thinking to improve our Credentialing system through better policies, tools, & data management.

You will report to the Senior Director Clinical Review.

Responsibilities:

  • Become the go-to individual at the company for Credentialing operations by serving as the primary subject matter expert in the regulatory & operational requirements of credentialing, re-credentialing, & delegated credentialing
  • Develop foundational processes for our scaling operations & summarize the complexity of our data & operations into clear explanations
  • Run & bring technical & operational improvements to Oscar's credentialing processes to ensure compliance, improve scalability, & manage risks
  • Support our credentialing regulatory activities, including auditing our partners & reporting any risks in our network to regulators & Oscar leadership
  • Work with Oscar's regulatory teams to refine our credentialing standards & policies
  • Provide analytical support & lead the process of collecting, analyzing, & reporting credentialing metrics
  • Surface data, process, & technology issues through identification, measurement, & monitoring of our operations
  • Manage & oversee daily interactions with the Credentials Verification Organization (CVO)
  • Organize & promote the Credentialing Committee meetings
  • Support your team & leadership by guiding decisions & implementation on an ongoing basis

Requirements:

  • 5+ years of operating experience
  • 3+ years of experience building & developing teams
  • Experience in operations management, insurance operations, credentialing, quality improvement (e.g, NCQA), consulting, and/or process improvement

Bonus points:

  • Experience leading & executing credentialing operations, including knowledge of NCQA & state specific credentialing standards.
  • CPCS certification
  • Technical aptitude & advanced Excel skills & familiarity with database languages (SQL)
  • Experience working with a Product and/or Engineering team to leverage technology in creative/novel ways to solve problems

Life at Oscar:

Our more than 1,000 employees aim to make health care affordable & accessible for all. We apply this same vision to our perks & benefits, including: medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, & volunteer opportunities.

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 & find both belonging & support. We're on a mission to change health care -- an experience made whole by your unique background & perspectives.

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.

 
 
 
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