Complex Case Management Nurse at Oscar Health

You are a registered nurse with at least two years of clinical experience in hospitals, payer settings, or outpatient care. You must hold an active, unrestricte

Work type: remote

Location: Remote

Salary: $39 – $46/hr

Type: Full-time

Summary

You are a registered nurse with at least two years of clinical experience in hospitals, payer settings, or outpatient care. You must hold an active, unrestricted RN license from a compact state or a state on their approved list and possess one year of dedicated experience in care coordination. **What makes it worth a look...** Oscar Health offers a remote position paying $39.28 to $45.94 per hour. You will also receive 15 days of vacation per year as part of their benefits package. **You might be a good fit if you...** * Hold an active, unrestricted RN license. * Possess over one year of experience in care coordination and navigation. * Have direct clinical experience with payer or hospital discharge planning. * Maintain familiarity with NCQA standards or Milliman Guidelines.

Job Description

Hi, we're Oscar. We're hiring a Complex Case Management Nurse to join our CCM 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 educate members on improving health outcomes, assist with transitions from care settings, participate in process improvement and other pilot programs as they arise, and work with support teams to ensure exceptional care for our members.

You will report into the Associate Director, Clinical.

Work Location:This is a remote position, open to candidates who reside in: Alabama; Arizona; Arkansas; Colorado; Connecticut; District of Columbia; Florida; Georgia; Idaho; Illinois; Indiana; Iowa; Kansas; Kentucky; Maine; Maryland; Massachusetts; Michigan; Minnesota; Missouri; Nevada; New Hampshire; New Jersey; New Mexico; North Carolina; Ohio; Oregon; Pennsylvania; Rhode Island; South Carolina; Tennessee; Texas; Utah; Vermont; or Virginia. 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: $39.28 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

• Assist in the coordination of care across a variety of settings (inpatient, outpatient, post acute, ER, home care)

• Actively reach out to members undergoing difficult health challenges and develop care plans

• Proactively reach out to hospital case managers to assist with discharge planning

• Communicate with members via phone or secure messaging to provide education on health conditions, new medications, and procedures

• Ensure compliance with all CCM NCQA standards in day to day practice and workflows.

• Compliance with all applicable laws and regulations

• Other duties as assigned

• Requirements:

• Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license

• Ability to obtain additional state licenses to meet business needs

• 2+ years of clinical experience to include payer, hospital, outpatient or community based care management

• 1+ years of experience in Care Coordination and Navigation

• CCM Certification

• NCQA knowledge and accreditation experience

• Bilingual in spanish and or creole reading, writing, speaking

• BSN

• Working knowledge of Milliman Guidelines

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.

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