Complex Case Management Clinical Supervisor

Oscar Health•Atlanta, GA

1d•Remote

About The Position

The Complex Case Management Clinical Supervisor leads a clinical team. You will act as both clinical support and leadership support for the team and is responsible for driving goals and KPIs for the clinical team to meet business objectives while providing coaching and leadership. This role is responsible for ensuring clear communication both internally and cross departmentally, guiding process improvement, escalating trends or concerns to appropriate stakeholders. Additionally, the role may be responsible for building relationships with external health systems and/or vendors as appropriate. You will report into the Manager, Clinical Programs.

Requirements

3+ years of experience in a healthcare setting as a nurse or social worker.
Complex Case Management 1+ years of case management experience at a managed care plan or provider organization
Active, unrestricted Nursing license (RN) in your state of hire and ability to obtain additional licensure as needed OR Masters in Social Work

Nice To Haves

NCQA knowledge
1+ year of previous leadership experience in a health care environment
Working knowledge of Milliman Care Guidelines or familiarity with UM guidelines
CCM certification
BSN or LMSW/LCSW
Bilingual in Spanish
Strong proficiency navigating Excel, JIRA, and SQL

Responsibilities

Lead team and department meetings, and participate in meetings with operations management and within the current department.
Be the clinical expert and resource for the team and other departments.
Promote team and vision and strategy to achieve department goals.
Provide consistent feedback to members of the team and company to produce positive results.
Lead and participate in continuous improvement activities that inspire or influence the improvement and development of a team.
Manage team's outcomes, monitor dashboards, and track operational KPIs, conducting root-cause analysis and constructing action plans when issues arise.
Manage daily needs of the team, personnel issues, payroll and attendance.
Monitor and approve PTO and sick time.
Assist with interviewing, hiring, and training as needed.
Provide coaching and support to the team to ensure growth and development.
Monitor QI and provide individual QI feedback to the team in 1:1's.
Uphold and enforce Oscar policies that drive accountability and alignment.
Compliance with all applicable laws and regulations
Other duties as assigned