Care Navigation Nurse

Oscar Health

2d • $39 - $46 • Remote

About The Position

This role requires extensive clinical knowledge and initiative to perform in-depth research, problem-solving, and decision-making to source and route to medically appropriate care, verify network gaps, escalate issues to appropriate stakeholders, guide the Care Navigation team in searches, and improve member experience. Additionally, you will provide ongoing clinical education to non-clinical teams to provide a strong foundation to be utilized in their workings with members.
You will report into the Clinical Care Navigation Lead.

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
• 3+ years of clinical experience to include hospital, outpatient or community based care management
• 3+ years of experience in Care Coordination and Navigation

Nice To Haves

• BSN
• Working knowledge of Milliman Guidelines
• CCM Certification
• Behavioral Health experience

Responsibilities

• Help coordinate 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.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Benefits

• medical, dental, and vision benefits
• 11 paid holidays
• paid sick time
• paid parental leave
• 401(k) plan participation
• life and disability insurance
• paid wellness time and reimbursements

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 1-10 employees