Remote Credentialing Operations Manager

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

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.