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[Remote] Complex Case Management Clinical Supervisor

Work from home Full-time role Hiring

Note: The job is a remote job and is open to candidates in USA. Oscar Health is a health insurance company focused on serving its members through a full stack technology platform. The Complex Case Management Clinical Supervisor will lead a clinical team, providing support and guidance to meet business objectives while ensuring effective communication and process improvement.

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

Skills

  • 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
  • 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

Benefits

  • Employee benefits
  • Participation in Oscar's unlimited vacation program
  • Annual performance bonuses
  • 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

Company Overview

  • Oscar is a health insurance company that offers individual and family plans, medicare advantages, and small group products. It was founded in 2012, and is headquartered in New York, New York, USA, with a workforce of 1001-5000 employees. Its website is http://www.hioscar.com.
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