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Salary: USD 67,813 - 98,894 / annual
Oscar Health is hiring a Case Manager to join its Complex Case Management team. Oscar is a health insurance company built on a full-stack technology platform with a focus on serving members through high-quality care and improved health outcomes.
In this role, you will collaborate across Oscar teams to deliver care coordination and improve member health outcomes. You will educate members on health conditions, evaluate Social Determinants of Health (SDOH), and connect individuals with community resources. You will coordinate care across multiple settings (inpatient, outpatient, ER, home care) while maintaining strict confidentiality and professional standards. You will partner with members and providers to navigate complex health challenges and create personalized care plans. You will provide crisis intervention support, act as a member advocate to resolve barriers to care, and engage directly with members via phone, secure messaging, or in-person. You will also contribute to process improvement initiatives and new pilot programs as required. You report to the Manager, Clinical Programs.
This is a remote position open to candidates residing in Arizona, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, or Virginia. Occasional travel may be required for team meetings and company events.
REQUIREMENTS:
- 2+ years of clinical experience in hospital, outpatient, or community-based care management
- 2+ years of experience working directly with patients with chronic medical conditions (e.g., diabetes, COPD, hypertension), with solid understanding of disease trajectories, treatment regimens, and symptom management
- 1+ years of experience in Care Coordination and Navigation
- Active, unrestricted RN licensure from the United States, OR active compact multistate unrestricted RN license, OR Masters in Social Work (MSW) from a graduate of a Nationally Accredited School approved by the Council on Social Work Education
BONUS QUALIFICATIONS:
- BSN
- Licensed Master Social Worker or Licensed Clinical Social Worker
- CCM Certification
- Case Management experience
- Complex Case Management certification
- Bilingual skills (Spanish)
