Senior Analyst, Credentialing Quality & Data Operations

Oscar-Health-

New York (NY)

Remote

USD 62,000 - 81,000

Full time

16 hours ago
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Benefits offered by this job

Unlimited vacation
Annual performance bonuses
Medical, dental, and vision benefits
401(k) plan

Job summary

Oscar Health in the United States is seeking a Senior Analyst to support credentialing quality, data operations, and provider workflows. The role emphasizes audits, analytics, and improving regulatory readiness and member outcomes.

You will turn findings into actionable recommendations, build reports and dashboards, and partner with multiple teams while reporting to the Senior Manager of Provider Operations Credentialing.

Qualifications

  • 3+ years in healthcare operations, credentialing, quality assurance, or data analysis.
  • 1+ years identifying risks or data issues and driving resolution.
  • Proficiency with Excel or Google Sheets for data validation and analysis.
  • Experience with credentialing quality audits and corrective-action follow-up.
  • Ability to learn credentialing concepts and data quickly.
  • Knowledge of credentialing requirements and regulatory standards.

Responsibilities

  • Perform credentialing, provider data, quality assurance, and analytics work per requirements and SLAs.
  • Evaluate credentialing records and data for accuracy and compliance.
  • Plan and conduct quality audits; document evidence and findings.
  • Analyze datasets to measure quality, productivity, and performance.
  • Build and validate reports, dashboards, and monitoring controls.
  • Translate audit results into corrective actions and process improvements.
  • Serve as credentialing resource for practitioner and facility data dependencies.
  • Support remediation of issues and track action plans to closure.
  • Coach teammates and manage assigned projects independently.

Skills

Healthcare operations experience
Data analysis
Root-cause analysis
Excel proficiency

Education

Credentialing/QA/data analytics certification

Tools

SQL
BigQuery
Data visualization tools

Job description

Senior Analyst, Credentialing Quality & Data Operations

Remote

Hi, we're Oscar. We're hiring a Senior Analyst to join our Credentialing Quality & Data Operations 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 Senior Analyst, Credentialing Quality & Data Operations supports the accuracy, quality, compliance, and continuous improvement of credentialing and provider operations. Depending on the assignment, this role may focus on credentialing quality audits, operational and performance analytics, or serving as a subject-matter expert for practitioner and facility credentialing. The Senior Analyst turns findings and data into clear recommendations, resolves complex issues, strengthens controls, and partners across teams to improve provider experiences, regulatory readiness, and member outcomes.

You will report into the Senior Manager of Provider Operations Credentialing.

Work Location

This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events.

Pay Transparency

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $68,724 - $90,200.25 per year. The base pay for this role in all other locations is: $61,851.60 - $81,180.23 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities
  • Perform complex operational work across credentialing, provider data, quality assurance, and analytics following applicable requirements, policies, procedures, and service-level expectations.
  • Evaluate practitioner and facility credentialing records, workflows, source documentation, and system data for accuracy, completeness, timeliness, consistency, and compliance.
  • Plan and complete risk-based or routine quality audits; select samples, document evidence, score results, identify error patterns, and communicate clear, supportable findings.
  • Analyze complex datasets using spreadsheets, reporting tools, database queries, or other analytical methods to measure quality, productivity, timeliness, inventory, and operational performance.
  • Build, maintain, and validate reports, dashboards, metrics, and monitoring controls; investigate data anomalies and reconcile information across sources of truth.
  • Perform root-cause analysis and translate audit results, data trends, and operational insights into corrective and preventive actions, process improvements, and measurable recommendations.
  • Be a credentialing resource on practitioner and facility requirements, including initial credentialing, recredentialing, verification, file review, committee preparation, delegated activities, and related provider data dependencies.
  • Support remediation of complex quality, data, or credentialing issues; track action plans through closure and validate that corrective actions are effective and sustained.
  • Coach team members and share subject-matter guidance.
  • Manage assigned projects, analyses, audits, escalations, and caseloads independently while meeting quality, documentation, and timeliness expectations.
  • Other duties as assigned.
Requirements
  • 3+ years of relevant experience in healthcare operations, credentialing, quality assurance or audit, provider data, data analysis, or a related field.
  • 1+ years of identifying risks or data issues, perform root-cause analysis, and driving work to resolution.
  • Intermediate proficiency with Excel or Google Sheets, including data validation, reconciliation, analysis, and clear presentation of findings.
  • Experience conducting healthcare credentialing quality audits, documentation, and corrective-action follow-up
  • Experience analyzing operational datasets and building reports or dashboards; extensive credentialing knowledge is not required, though the ability to learn credentialing concepts and data is essential.
  • Knowledge of practitioner and facility credentialing (including primary-source verification and regulatory requirements),
  • Experience in a health plan, delegated credentialing entity, credentialing verification organization, provider organization, or other regulated healthcare environment.
  • Proficiency with SQL, BigQuery, or a similar query language and experience working with large datasets, data models, visualization tools, or business‑intelligence platforms.
  • Experience using credentialing, provider data, workflow, ticketing, or audit‑management systems.
  • Knowledge of NCQA, CMS, state, federal, and delegated‑oversight requirements relevant to credentialing operations.
  • Relevant professional certification or formal training in credentialing, healthcare quality, auditing, compliance, or data analytics.

This is an authentic Oscar Health job opportunity.

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.

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

California Residents

For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy .

Benefits
  • You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.
  • 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.

Oscar Health is authorized to do business in many, but not all, states. If you are not located in or willing to relocate to a state where Oscar is registered, you will not be eligible for employment. The approved states for this role are listed in the job posting.

Voluntary Self‑Identification

For government reporting purposes, we ask candidates to respond to the below self‑identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file.

As set forth in Oscar Health’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service‑connected disability.

A "recently separated veteran" means any veteran during the three‑year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

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