Care Navigation Nurse

Hi, we're Oscar. We're hiring a Care Navigation Nurse to join our Care Navigation 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

This role requires extensive clinical knowledge and initiative to perform in-depth research, problem-solving, and decision-making to source and route to medically appropriate care, verify network gaps, escalate issues to appropriate stakeholders, guide the Care Navigation team in searches, and improve member experience. Additionally, you will provide ongoing clinical education to non-clinical teams to provide a strong foundation to be utilized in their workings with members.

You will report into the Clinical Care Navigation Lead.

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. 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 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

Help coordinate 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

3+ years of clinical experience to include hospital, outpatient or community based care management

3+ years of experience in Care Coordination and Navigation

Bonus Points

BSN

Working knowledge of Milliman Guidelines

CCM Certification

Behavioral Health experience

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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)

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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 (accommodations@hioscar.com) to make the need for an accommodation known.

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