Responsibilities

The Senior Analyst, Credentialing Data Operations supports the accuracy, quality, compliance, and continuous improvement of credentialing and provider operations. This role will focus on credentialing quality, operational and performance analytics for practitioner and facility credentialing. The Senior Analyst turns findings and data into clear recommendations, resolves complex issues, strengthens controls, and partners across teams to improve provider experiences, regulatory readiness, and member outcomes.
Work Location: 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. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote
Pay Transparency: The base pay for this role is: $61,851 - $80,000 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.
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 that corrective actions are effective and sustained.
Coach team members and share subject-matter guidance.
Manage assigned projects, analyses, audits, escalations, and caseloads independently while meeting quality, documentation, and timeliness expectations.
Other duties as assigned

Qualification

Strong attention to detailExperience in a health planProficiency with SQLExperience using credentialingKnowledge of NCQAAt OscarPay Transparency

Required

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; extensive credentialing knowledge is not required, though the ability to learn credentialing concepts and data is essential.

Preferred

Experience in a health plan, delegated credentialing entity, credentialing verification organization, provider organization, or other regulated healthcare environment.
Proficiency with SQL, BigQuery, or a similar query language and experience working 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.
This is an authentic Oscar Health job opportunity.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Senior Analyst, Credentialing Data Operations at Oscar · LumiJobs

Senior Analyst, Credentialing Data Operations

Responsibilities

Qualification

Required

Preferred

Benefits

Company

Oscar

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