Specialist, Provider Data Operations

Job Description

Job Description

Hi, we're Oscar. We're hiring a Specialist, Provider Data Operations to join our Provider Operations team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

You will be responsible for the accurate management and maintenance of provider data at Oscar. Key responsibilities include processing provider and facility rosters, reformatting data, and supporting updates to provider records. This role involves regular communication with providers via email to confirm request completion, obtain additional information, and address follow-up inquiries. You will also collaborate with internal teams by triaging, remediating, and escalating requests as necessary to ensure timely and effective resolution.

You will report into the Provider Operations Lead.

Work Location: This is a remote position, open to candidates who reside in: Georgia . While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The set pay rate for this role is $24.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

• Maintain existing and incoming provider demographic information to ensure accuracy and quality of the network by supporting run-state, repeatable issues of moderate complexity. .
• Manage ingestion of provider data while maintaining service delivery, productivity, and quality expectations
• Surface various provider issues within standard operating procedure through proactive identification, measurement, and monitoring of our operations and provide feedback to reduce errors, improve processes, and performance
• Build training materials, update workflows, and support team lead or SME in coaching
• Support driving and tracking business decisions, develop initial root cause analyses and reports for review by team leads and SMEs.
• Assist in developing and maintaining standards for quality assurance, leading corrective activities and manage communication processes with other departments regarding improvements.
• Escalate and resolve provider data issues to ensure appropriate turnaround times
• Support more junior employees through provider data escalation research and re
• solution Drive decisions within standard operating procedures
• Effectively communicate findings and resolutions with key stakeholders internally and/or externally
• Manage queue work and assigned caseload through effective dashboard management while ensuring integrity of information entered into company and/or external systems
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• 2+ years of work experience in healthcare working with provider data management
• 2+ years of intermediate Excel/Google Sheet proficiency
• 1+ years of assessing and comprehending end to end process impact
• 2+ years strong quantitative or analytical skills focused on proactively identifying or solving problems
• 2+ years previous work experience in a fast-paced production-based environment

Bonus points:

• Bachelor's Degree
• Lean Six Sigma or similar operations certifications
• 1 year of entry level proficiency in SQL, BigQuery or similar database language experience
• Prior work experience in tech and/or healthcare
• Proficiency in using a credentialing or provider data repository
• Experience working with large datasets, data verification, data management, data modeling
• Experience with healthcare data such as provider and/or claims data

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

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.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([email protected]) to make the need for an accommodation known.

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