Oscar Health - Case Manager

Remote - Anywhere - USA *$76k - $99k1w ago

Remote Junior NA Hospitals Healthcare Community Manager Care Coordination Case Management

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 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. • 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.

Responsibilities

• Coordinate care across settings (inpatient, outpatient, ER, 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 drive 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 via 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 duties as assigned.