Case Manager (CCM)

Job Description

Job Description

Hi, we're Oscar. We're hiring a Case Manager to join our Complex Case Management 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:

The Case Manager collaborates across Oscar teams to deliver high-quality care and improve member health outcomes. In this role, the Case Manager will educate members, evaluate Social Determinants of Health (SDOH), and connect individuals with community resources while contributing to process improvement initiatives and new pilot programs as required.

You will report into our Manager, Clinical Programs.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio;Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.

Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $75,348 - $98,894 per year. The base pay for this role in all other locations is: $67,813- $89,005. You are also eligible for employee benefits, monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

• Coordinate care across settings (inpatient, outpatient, ER, or home care) while maintaining strict confidentiality and high professional standards.
• Partner with members and providers to navigate complex health challenges and create personalized care plans that create better clinical outcomes.
• Assess and address Social Determinants of Health (SDOH) by connecting members with tailored community support resources.
• Provide crisis intervention support and act as a dedicated member advocate to resolve barriers to care and treatment compliance.
• Engage directly with members by phone, secure messaging, or in-person, to provide education on health conditions, hospital discharges, medical procedures, and new prescriptions.
• Compliance with all applicable laws and regulations.
• Other responsibilities as assigned.

Requirements:

• 2+ years of clinical experience to include hospital, outpatient or community-based care management.
• 2+ years of experience working directly with patients with chronic medical conditions (e..g diabetes, COPD, hypertension), demonstrating a solid understanding of disease trajectories, common treatment regimens, and symptom management.
• 1+ years experience Care Coordination and Navigation.
• Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license or Masters in Social Work (MSW) from a graduate of a Nationally Accredited School approved by the Council on Social Work Education.

Bonus points:

• BSN
• Licensed Master Social Worker or Licensed Clinical Social Worker
• CCM Certification
• Case Management experience
• Complex Case Management certification
• Bilingual skills (Spanish)

This is an authentic Oscar Health job opportunity.

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.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

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.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (View email address on us.fitly.work) to make the need for an accommodation known.

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.