Senior Analyst, Credentialing Quality & Data Operations

Job not on LinkedIn

🔥 0 minutes ago

🌵 Arizona, California, +4 more states – Remote

🌵 Arizona – Remote 🏄 California – Remote 🦌 Connecticut – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote ☕ Washington – Remote

💵 $61.9k - $81.2k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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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 • 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 findings • Analyze complex datasets using spreadsheets, reporting tools, database queries, or other analytical methods • 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 recommendations • Serve as a credentialing resource on practitioner and facility requirements, including initial credentialing, recredentialing, verification, file review, committee preparation, delegated activities, and provider data dependencies • 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 • Report to the Senior Manager of Provider Operations Credentialing • Perform 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, performing 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 • Ability to learn credentialing concepts and data • Knowledge of practitioner and facility credentialing, including primary-source verification and regulatory requirements • Must reside in the U.S., excluding Alaska, Delaware, Hawaii, Louisiana, Montana, North Dakota, Oklahoma, West Virginia, Wyoming, and U.S. Territories

🏖️ 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 • Wellness reimbursements • Occasional travel for team meetings and company events