Associate Manager, Credentialing Operations Insurance Operations

Oscar Health Insurance; Northern (KY); Hybrid; USD 65,000 - 85,000; Full time

Benefits offered by this job

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

Job summary

Oscar is seeking an Associate Manager, Credentialing Operations to lead a team ensuring accurate and timely provider credentialing and re-credentialing. You will oversee production, quality, service levels, and regulatory compliance while driving improvements with data and cross-functional collaboration.

You will report to the Senior Manager, Provider Operations Credentialing. This remote role is open to candidates in AZ, FL, GA, or TX, with occasional travel for team meetings and events.

Qualifications

• 3+ years of direct people management experience.
• 2+ years in provider credentialing, re-credentialing, provider enrollment, or 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.
• Strong proficiency navigating Excel/Google Sheets, JIRA, and/or SQL.
• Working knowledge of credentialing standards and requirements (NCQA, CMS, state).
• Experience leading credentialing operations for health plans/health systems.
• Bachelor’s Degree required.

Responsibilities

• Evaluates departmental performance by data analysis and metrics.
• Lead day-to-day credentialing operation including workload planning and queue management.
• Collaborate with internal/external stakeholders for change management and risk mitigation.
• Conduct root-cause analysis on systemic issues and craft action plans.
• Maintain and report on team KPIs to meet objectives.
• Hire and manage a team with performance management and HR tasks.
• Ensure compliance with laws and regulations.

Skills

People management

Credentialing

Healthcare operations

Data-driven decisions

Excel/Sheets

JIRA

SQL

Education

Bachelor's Degree

Tools

Excel

Google Sheets

JIRA

SQL

Job description

Associate Manager, Credentialing Operations

Remote

Hi, we're Oscar. We're hiring an Associate Manager, Credentialing Operations to join our Credentialing 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:

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 is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or 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 base pay for this role 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

Requirements:

• 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
• 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

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.

• 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

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 ([e-mail]) to make the need for an accommodation known.

California Residents:

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