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Oscar Health // health insurance
 
Tempe, Arizona, United States    Posted: Tuesday, August 25, 2020
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. Were hiring a Case Manager Lead for our Clinical Concierge team in our Tempe, Arizona office. 

Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 & headquartered in New York City. Our goal is to make health insurance simple, transparent, & human. We need your help to do so.

About this role:

In this role you will be responsible for leading a clinical team. You will act as clinical support for case managers through a prominent presence on the floor. You will ensure there is clear communication throughout the team, communicate both internally & cross departmentally guide process improvement & escalate trends or concerns to appropriate stakeholders, ensuring workflows are communicated back to individual teams. You will be responsible for owning your specific region & building relationships with external health systems and/or vendors.

You will report into the Associate Director, Case Management.

 Responsibilities:

  • Coaching

    • Handle escalations to include next steps, blockers to care, support workflow issues, answer general questions, provide coordination between & within departments.

    • Responsible for ticket/call audits & providing feedback. 

    • Scheduled side-by-side time with all staff to support real time coaching

  • Clinical Education & Concierge Support

    • Communication

      • Own CM Weekly Team Meetings

      • Sync with Ops Lead 2

      • Act as clinical platform experts

  • Process Improvement 

    • Shape clinical workflow

    • Improve efficiencies

    • Build regional specific relationships with external health systems/vendors.

  • Lead / Support 

    • Provide hands-on support for MMs as needed

    • Comment in tickets as necessary to push issues forward

    • Administrative Support for CM Department

      • PTO approvals

      • Approve & ensure sick time coverage

      • Support of day to day personnel issues

  • Quality Assurance

    • Complete QI for tickets & review calls then relay feedback to Case Managers in monthly 1:1s 

    • Involved in performance reviews for Concierge Team Case Managers

Requirements

  • Active, unrestricted AZ license (RN) & ability to obtain additional licensure as needed OR Masters in Social Work, LCSW/LMSW preferred

  • 2 years of case management experience at a managed care plan or provider organization or at least 1 year of previous leadership experience in a health care environment

  • Working knowledge of Milliman Care Guidelines

  • Adherence to all member privacy & confidentiality standards of practice (i.e. HIPAA)

Life at Oscar: 

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 & find both belonging & support. We're on a mission to change health care -- an experience made whole by our unique backgrounds & perspectives.

We aim to make health care affordable & accessible for all, & apply this same vision to our perks & benefits, including: medical benefits, unlimited paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, & volunteer opportunities.

Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicants disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

Pay Transparency Policy:

Oscar ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.

 
 
 
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