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Salary: USD 61,851.6 - 90,200.25 / annual
Oscar Health is seeking a Senior Analyst to join the Credentialing Quality & Data Operations Team. Oscar is a technology-driven health insurance company founded in 2012, built on a full-stack platform with a focus on member experience and provider relationships.
In this role, you will support the accuracy, quality, compliance, and continuous improvement of credentialing and provider operations. Depending on assignment, you may focus on credentialing quality audits, operational and performance analytics, or serve as a subject-matter expert for practitioner and facility credentialing. You will turn findings and data into clear recommendations, resolve complex issues, strengthen controls, and partner across teams to improve provider experiences, regulatory readiness, and member outcomes. You will report to the Senior Manager of Provider Operations Credentialing.
Key responsibilities include:
- Perform complex operational work across credentialing, provider data, quality assurance, and analytics following applicable requirements, policies, and procedures
- 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 clear findings
- Analyze 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 sources
- Perform root-cause analysis and translate audit results, data trends, and operational insights into corrective and preventive actions and measurable recommendations
- Serve as a credentialing resource on practitioner and facility requirements, including initial credentialing, recredentialing, verification, file review, and related provider data dependencies
- Support remediation of complex quality, data, or credentialing issues; track action plans through closure and validate effectiveness
- Coach team members and share subject-matter guidance
- Manage assigned projects, analyses, audits, escalations, and caseloads independently while meeting quality and timeliness expectations
Work is fully remote from your home office, with occasional travel required for team meetings and company events. The role is open to candidates residing in the U.S., excluding Alaska, Delaware, Hawaii, Louisiana, Montana, North Dakota, Oklahoma, West Virginia, Wyoming, and U.S. Territories.
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; extensive credentialing knowledge is not required, though the ability to learn credentialing concepts and data is essential
- Knowledge of practitioner and facility credentialing, including primary-source verification and regulatory requirements
Bonus qualifications:
- Experience in a health plan, delegated credentialing entity, credentialing verification organization, provider organization, or other regulated healthcare environment
- Proficiency with SQL, BigQuery, or similar query language and experience with large datasets, data models, visualization tools, or business-intelligence platforms
- Experience using credentialing, provider data, workflow, ticketing, or audit-management systems
- Knowledge of NCQA, CMS, state, federal, and delegated-oversight requirements relevant to credentialing operations
- Relevant professional certification or formal training in credentialing, healthcare quality, auditing, compliance, or data analytics
