Specialist, Provider Operations

Hi, we're Oscar. We're hiring a Specialist to join our Oscar Medical Group 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:

The Provider Operations Specialist owns the end-to-end licensure and cross-license tracking for all Oscar Medical Group (OMG) providers across all service lines. Operating within standard procedures and practices, you will ensure 100% compliance with applicable laws and regulations by keeping all internal tracking and real-time monitoring systems instantaneously updated. You will work on problems of moderate scope, using strong problem-solving skills and collaborative internal and external relationships to maintain regulatory alignment, prevent licensure lapses, and support provider operations.

You will report into the Associate Manager of OMG Provider Operations

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: $20.00 - $30.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year

Responsibilities:

• Own end-to-end licensure, cross-licensing, and primary source verification for all Oscar Medical Group (OMG) providers across all service lines, ensuring internal tracking systems stay fully compliant with state and federal regulations.
• Oversee credential verification processes across state licensing boards to maintain high standards of data accuracy, regulatory compliance, and safety.
• Proactively audit, track, and process initial and renewal license requests to eliminate coverage gaps, while managing reinstatements for any lapsed credentials.
• Be the primary escalation point for complex licensing and supervision issues, delivering real-time guidance to Virtual Care Operations and leadership.
• Oversee physician supervision assignments for newly hired and newly licensed APPs to maintain full compliance with state regulatory standards.
• Research state board requirements to build compliant workflows for APP/physician collaborations, managing reassignments to align with operational and patient care needs.
• Exercise sound judgment within standard operating procedures to resolve moderate-scope operational issues, analyzing key data for senior review and building stakeholder relationships aligned with corporate values.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• 2+ years of experience with MS Excel or Sheets (including mathematical formulas, pivot tables, conditional formatting, data validation, nested IF statements).
• 2+ years of experience in Workforce Management, planning/scheduling, or operations.
• 1+ years of experience in a "customer-facing" role (even if the "customer" is internal).

Bonus points:

• 1+ years of experience using WFM tools (NICE, InContact, Five9, Verint)
• 1+ years of experience in real-time workforce analysis

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.

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