Associate Manager, Credentialing Operations
About the role
About the role
Work Location
Pay Transparency
Responsibilities
- Evaluates overall departmental performance by creating, gathering, analyzing and interpreting data and metrics as well as assisting in development of departmental metrics and implementation of mitigation strategies
- Lead the day-to-day credentialing operation, including workload planning, queue management, service-level performance, quality, and issue resolution
- Collaboratively works with all relevant internal and external stakeholder groups to formulate proactive implementation, communications, and program strategies for successful change management and risk mitigation initiatives
- Conduct root-cause analysis on systemic issues and construct action plans to address
- Maintains, analyzes, and communicates reporting on assigned team KPIs. Track monthly and quarterly to meet departmental objectives
- Hire and manage a team of Oscar colleagues with direct responsibility for performance management, their growth and development, and associated HR administrative tasks
- Compliance with all applicable laws and regulations
- Other duties as assigned
Requirements
- 3+ years of direct people management experience
- 2+ years of experience in provider credentialing, re-credentialing, provider enrollment, or a closely related function
- 3+ years of healthcare operations experience supporting high-volume production teams
- 1+ year experience using data to drive decision making and continuous improvement
Bonus points
- Strong proficiency navigating Excel/Google Sheets, JIRA, and/or SQL
- Working knowledge of credentialing standards and requirements, including NCQA, CMS, state, and delegated-credentialing requirements
- Experience supporting process improvement initiatives cross-functionally
- Bachelor's Degree
- Experience leading credentialing operations for a health plan, health system, provider organization, or credentials verification organization
- Prior healthcare or insurance-related experience
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Pay Transparency
Artificial Intelligence (AI)
Reasonable Accommodation
California Residents
Not included in the source posting: about the role, benefits.
Skills
Who can apply
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