Sr. Specialist, Credentialing

Oscar Health

5d•Remote

About The Position

You will solve complex issues or concerns impacting our provider credentialing process. You will act as a subject matter expert for credentialing. You will work cross functionally between teams across Oscar. You will track and trend provider and facility credentialing issues and partner with stakeholders to resolve escalated issues. You will support process improvement processes for the credentialing team. You will report into the Manager, Provider Credentialing. Work Location: This is a remote position, open to candidates who reside in: 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 hourly pay for this role is: $24.00/hr. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Requirements

1+ years of credentialing experience for facilities, adhering to NCQA standards
2+ years previous work experience in a fast-paced volume-based environment
2+ years strong quantitative or analytical skills focused on proactively identifying or solving problems
Experience working in health insurance

Nice To Haves

Bachelor's Degree
High school diploma or GED
1+ years of credentialing experience for practitioners, adhering to NCQA standards
Background in health insurance
Proficiency with non Microsoft business platforms
Proficiency in using a credentialing or provider data repository
Primary Source Verification
Experience with healthcare data such as provider data
Strong verbal and written communications, and interpersonal interactions

Responsibilities

Support, manage, or escalate complex issues that are not solved using conventional workflows.
Effectively manage internal or external escalated transactions and communicate with appropriate parties for effective resolution in adherence to SLAs
Act as a point person for stakeholders in other areas of the business to improve feedback loops and trend facility and provider credentialing issues
Manage queue work and and assigned caseload through efficient dashboard management
Collaborate daily with production and credentialing leaders on systemic issues and communicate blockers to care and satisfaction
Compliance with all applicable laws and regulations
Other duties as assigned