Care Navigation Nurse

1 hour, 35 minutes ago
Full-time
Mid Level
Customer and Technical Support
Oscar

Oscar

Oscar is a health insurance company that offers plans for individuals, families, and small businesses. With a focus on humanizing health care through technology, design, and data, Oscar provides easy-to-understand bills, 24/7 access to doctors, and a p...

Insurance
1K-5K
Founded 2012

Description

  • Coordinate care across inpatient, outpatient, post-acute, emergency room, and home care settings.
  • Reach out to members facing complex health challenges and develop care plans.
  • Proactively contact hospital case managers to support discharge planning.
  • Communicate with members by phone or secure messaging about health conditions, new medications, and procedures.
  • Research and identify medically appropriate care options and route members accordingly.
  • Verify network gaps and escalate issues to the appropriate stakeholders.
  • Guide the Care Navigation team in care searches and problem-solving.
  • Provide ongoing clinical education to non-clinical teams.
  • Ensure compliance with all applicable laws and regulations.
  • Perform other duties as assigned.

Requirements

  • Active, unrestricted RN licensure in the United States for the listed state, or an active compact multistate unrestricted RN license.
  • Ability to obtain additional state licenses as business needs require.
  • 3+ years of clinical experience in hospital, outpatient, or community-based care management.
  • 3+ years of experience in care coordination and navigation.
  • BSN preferred.
  • Working knowledge of Milliman Guidelines preferred.
  • CCM certification preferred.
  • Behavioral health experience preferred.

Benefits

  • Base pay of $39.28 to $45.94 per hour.
  • Monthly vacation accrual at a rate of 15 days per year.
  • 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.

Interested in this position?

Apply directly on the company website

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