Specialist, Provider Data Operations
About The Position
Oscar is hiring a Specialist, Provider Data Operations to join their Provider Operations team. Oscar is a health insurance company that utilizes a full stack technology platform and focuses on serving its members. The Specialist will be responsible for the accurate management and maintenance of provider data at Oscar. Key responsibilities include processing provider and facility rosters, reformatting data, and supporting updates to provider records. This role involves regular communication with providers via email to confirm request completion, obtain additional information, and address follow-up inquiries. The Specialist will also collaborate with internal teams by triaging, remediating, and escalating requests as necessary to ensure timely and effective resolution. The role reports into the Provider Operations Lead.
Requirements
- 2+ years of work experience in healthcare working with provider data management
- 2+ years of intermediate Excel/Google Sheet proficiency
- 1+ years of assessing and comprehending end to end process impact
- 2+ years strong quantitative or analytical skills focused on proactively identifying or solving problems
- 2+ years previous work experience in a fast-paced production-based environment
Nice To Haves
- Bachelor's Degree
- Lean Six Sigma or similar operations certifications
- 1 year of entry level proficiency in SQL, BigQuery or similar database language experience
- Prior work experience in tech and/or healthcare
- Proficiency in using a credentialing or provider data repository
- Experience working with large datasets, data verification, data management, data modeling
- Experience with healthcare data such as provider and/or claims data
Responsibilities
- Maintain existing and incoming provider demographic information to ensure accuracy and quality of the network by supporting run-state, repeatable issues of moderate complexity.
- Manage ingestion of provider data while maintaining service delivery, productivity, and quality expectations
- Surface various provider issues within standard operating procedure through proactive identification, measurement, and monitoring of our operations and provide feedback to reduce errors, improve processes, and performance
- Build training materials, update workflows, and support team lead or SME in coaching
- Support driving and tracking business decisions, develop initial root cause analyses and reports for review by team leads and SMEs.
- Assist in developing and maintaining standards for quality assurance, leading corrective activities and manage communication processes with other departments regarding improvements.
- Escalate and resolve provider data issues to ensure appropriate turnaround times
- Support more junior employees through provider data escalation research and resolution
- Drive decisions within standard operating procedures
- Effectively communicate findings and resolutions with key stakeholders internally and/or externally
- Manage queue work and assigned caseload through effective dashboard management while ensuring integrity of information entered into company and/or external systems
- Compliance with all applicable laws and regulations
- Other duties as assigned
Benefits
- 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
- monthly vacation accrual at a rate of 15 days per year
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
