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Remote Credentialing Verification Organization Jobs in Georgia

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Remote Credentialing Verification Organization information

What is the difference between Remote Credentialing Verification Organization vs Credentialing Specialist?

AspectRemote Credentialing Verification OrganizationCredentialing Specialist
Primary RoleProvides credentialing verification services for healthcare providers remotelyPerforms credentialing tasks directly for healthcare facilities or providers
Work EnvironmentTypically operates remotely, often for multiple clientsUsually works in healthcare facilities or administrative offices
Required CredentialsKnowledge of credentialing standards, healthcare regulationsCertifications like Certified Provider Credentialing Specialist (CPCS) often preferred

The main difference is that a Remote Credentialing Verification Organization offers credentialing services remotely for multiple clients, while a Credentialing Specialist performs credentialing tasks directly within healthcare organizations. Both roles require knowledge of healthcare standards, but their work settings and scope differ.

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The most popular types of Credentialing Verification Organization jobs in Georgia are:

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Cities in Georgia with the most Remote Credentialing Verification Organization job openings:

Remote Credentialing Verification Organization jobs near you

Associate Manager, Credentialing Operations

Oscar Health

Atlanta, GA • Remote

$64K - $85K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago

New

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

264th of 315 rated insurance

Job description

Hi, we're Oscar. We're hiring an Associate Manager, Credentialing Operations to join our Credentialing 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:

The Associate Manager, Credentialing Operations leads a team responsible for accurate and timely provider credentialing and re-credentialing. This role oversees production, quality, service levels, and escalations and ensures compliance with applicable regulatory, accreditation, contractual, and internal requirements. The Associate Manager uses performance data and cross-functional partnerships to improve workflows, mitigate risk, strengthen provider experience, and maintain network readiness.

You will report into the Senior Manager, Provider Operations Credentialing.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. 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 base pay for this role is: $64,832 - $85,092 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

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

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 (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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