Case Management Nurse

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.You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #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.
• 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
• Bonus points:
• CCM Certification
• Bilingual in Spanish and/or creole reading, writing, speaking
• BSN
• Working knowledge of Milliman Guidelines
• This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here .
• Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.
• California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy .

Benefits

Additional Information

Hi, we're Oscar. We're hiring a Case Management Nurse to join our Case Mangement 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.

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