Senior Analyst, Credentialing Data Operations

🔥 1 minute ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $61.9k - $80k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

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Oscar Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2012

⚕️ Healthcare Insurance

🏥 Healthcare

💰 $355M Post-IPO Debt - Oscar Health on 2025-09

Healthcare Insurance • Healthcare

Oscar Health is a technology-driven health insurance company that provides individual, family, and small-group health plans in multiple U. S. states. Oscar combines traditional insurance underwriting with digital-first services — a consumer-facing app, 24/7 virtual urgent care, prescription delivery (including $3 meds in many plans), and dedicated Care Teams — and also operates Oscar Primary Care in some markets. The company emphasizes accessible, affordable, high-quality care and uses AI to improve member experience and care delivery. Insurance policies are underwritten by Oscar's state insurance subsidiaries and the company offers both HMO and other plan types across its markets.

📋 Description

• Perform complex operational work across credentialing, provider data, quality assurance, and analytics in accordance with 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 • Analyze large or 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 systems or 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 • Lead or support remediation of complex quality, data, or credentialing issues; track action plans through closure and validate corrective actions • Coach team members and share subject-matter guidance • Manage assigned projects, analyses, audits, escalations, and caseloads independently • Comply with all applicable laws and regulations • Report to the Senior Manager of Provider Operations Credentialing

🎯 Requirements

• 3+ years of relevant experience in healthcare operations, credentialing, quality assurance or audit, provider data, data analysis, or a related field • Demonstrated ability to assess end-to-end processes, identify risks or data issues, perform root-cause analysis, and drive work to resolution • Intermediate proficiency with Excel or Google Sheets, including data validation, reconciliation, analysis, and clear presentation of findings • Strong attention to detail, judgment, written communication, and ability to explain complex findings to varied audiences • Ability to manage multiple priorities independently and collaborate effectively in a regulated, cross-functional environment • Demonstrated experience analyzing operational datasets and building reports or dashboards • Ability to learn credentialing concepts and data • Bonus: Experience in a health plan, delegated credentialing entity, credentialing verification organization, provider organization, or other regulated healthcare environment • Bonus: Proficiency with SQL, BigQuery, or a similar query language and experience working with large datasets, data models, visualization tools, or business-intelligence platforms • Bonus: Experience using credentialing, provider data, workflow, ticketing, or audit-management systems • Bonus: Knowledge of NCQA, CMS, state, federal, and delegated-oversight requirements relevant to credentialing operations • Bonus: Relevant professional certification or formal training in credentialing, healthcare quality, auditing, compliance, or data analytics

🏖️ Benefits

• Employee benefits • Unlimited vacation program • Annual performance bonuses • Medical benefits • Dental benefits • Vision benefits • 11 paid holidays • Paid sick time • Paid parental leave • 401(k) plan participation • Life insurance • Disability insurance • Paid wellness time and reimbursements • Occasional travel for team meetings and company events

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