Senior Analyst, Credentialing Data Operations
New
O
OscarHealth insurance
This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories.Full-TimeSenior
SalaryThe base pay for this role is: $61,851 - $80,000 per year.
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Job Details
- Experience
- 3+ years of relevant experience in healthcare operations, credentialing, quality assurance or audit, provider data, data analysis, or a related field.
- Required Skills
- SQLMicrosoft ExcelQuality AssuranceGoogle SheetsBigQuery
Requirements
- Have 3+ years of relevant experience in healthcare operations, credentialing, quality assurance or audit, provider data, data analysis, or a related field.
- Be able to assess end-to-end processes, identify risks or data issues, perform root-cause analysis, and drive work to resolution.
- Have intermediate proficiency with Excel or Google Sheets, including data validation, reconciliation, analysis, and presentation of findings.
- Have experience analyzing operational datasets and building reports or dashboards.
- Be able to manage multiple priorities independently and collaborate in a regulated, cross-functional environment.
- Bring strong attention to detail, judgment, and written communication skills, including the ability to explain complex findings to varied audiences.
- SQL, BigQuery, or similar query-language proficiency and experience with large datasets, data models, visualization tools, or business-intelligence platforms are bonuses.
- Experience with credentialing, provider data, workflow, ticketing, or audit-management systems is a bonus.
- Knowledge of NCQA, CMS, state, federal, and delegated-oversight requirements relevant to credentialing operations is a bonus.
- Relevant professional certification or formal training in credentialing, healthcare quality, auditing, compliance, or data analytics is a bonus.
Responsibilities
- 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.
- Analyze datasets 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 actions and process improvements.
- Lead or support remediation of complex quality, data, or credentialing issues and track action plans through closure.
- Coach team members and share subject-matter guidance.
- Manage assigned projects, analyses, audits, escalations, and caseloads independently.
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