Case Manager
About The Position
Oscar is hiring a Case Manager for its Care Delivery - Clinical team. The role collaborates across Oscar teams to deliver high-quality care and improve member health outcomes. The Case Manager educates members, evaluates Social Determinants of Health (SDOH), connects individuals with community resources, and contributes to process improvement initiatives and pilot programs as needed. The position reports to the Case Management supervisor. This is a fully remote position for candidates residing in eligible U.S. locations, excluding Alaska, Delaware, Hawaii, Louisiana, Montana, North Dakota, Oklahoma, West Virginia, Wyoming, and U.S. Territories. Work is completed from a home office, with occasional travel for team meetings and company events.
Requirements
- At least 2 years of clinical experience, including hospital, outpatient, or community-based care management.
- At least 2 years of experience working directly with patients with chronic medical conditions such as diabetes, COPD, or hypertension, with an understanding of disease trajectories, common treatment regimens, and symptom management.
- At least 1 year of experience in care coordination and navigation.
- Active, unrestricted U.S. RN licensure, an active compact multistate unrestricted RN license, or a Master of Social Work (MSW) from a graduate of a Nationally Accredited School approved by the Council on Social Work Education.
Nice To Haves
- BSN.
- Licensed Master Social Worker or Licensed Clinical Social Worker.
- CCM certification.
- Case management experience.
- Complex Case Management certification.
- Bilingual skills in Spanish.
Responsibilities
- Coordinate care across inpatient, outpatient, emergency room, and home-care settings while maintaining confidentiality and professional standards.
- Partner with members and providers to navigate complex health challenges and create personalized care plans to improve clinical outcomes.
- Assess Social Determinants of Health (SDOH) and connect members with tailored community support resources.
- Provide crisis intervention and advocate for members to resolve barriers to care and treatment compliance.
- Engage with members by phone, secure messaging, or in person to educate them about health conditions, hospital discharges, medical procedures, and new prescriptions.
- Comply with applicable laws and regulations.
- Perform other duties as assigned.
Benefits
- Employee benefits and monthly vacation accrual at a rate of 15 days per year.
- 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.
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What This Job Offers
Job Type
Full-time
