Case Manager

Oscar Health; United States; Remote; USD 68,000 - 99,000; Full time

Benefits offered by this job

Remote-friendly role

15 days paid vacation per year

Job summary

Oscar Health is hiring a Case Manager to join the Care Delivery - Clinical team. The role focuses on educating members, evaluating Social Determinants of Health (SDOH), and connecting individuals with community resources to improve health outcomes.

You will collaboratively work across Oscar teams, reporting to the Case Management supervisor, with a fully remote setup for candidates in most US states (excluding certain states). Benefits and a 15-day annual vacation accrual accompany the role.

Qualifications

• 2+ years of clinical experience in hospital, outpatient, or community case management.
• 2+ years of experience working with patients with chronic conditions (diabetes, COPD, hypertension).
• 1+ years of Care Coordination and Navigation.
• Active, unrestricted RN license in the United States or compact multistate license or MSW from CSWE-accredited school.
• BSN; Licensed MSW/LSW or Licensed Clinical Social Worker.
• CCM Certification and Complex Case Management certification.

Responsibilities

• Coordinate care across inpatient, outpatient, ER, and home care while maintaining confidentiality and professional standards.
• Partner with members and providers to navigate health challenges and create personalized care plans.
• Assess Social Determinants of Health (SDOH) and connect members with community resources.
• Provide crisis intervention and advocate for members to resolve barriers to care and treatment adherence.
• Educate members via phone, secure messaging, or in person about health conditions, discharges, procedures, and new prescriptions.

Skills

Clinical experience

Care coordination

Chronic disease management

Patient education

Education

BSN

RN licensure (US) or compact license

MSW from CSWE-accredited program

CCM Certification

Complex Case Management Certification

Job description

Hi, we're Oscar. We're hiring a Case Manager to join our Care Delivery - Clinical 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:

The Case Manager collaborates across Oscar teams to deliver high-quality care and improve member health outcomes. In this role, the Case Manager will educate members, evaluate Social Determinants of Health (SDOH), and connect individuals with community resources while contributing to process improvement initiatives and new pilot programs as required.

You will report into the Case Management supervisor.

Work Location: This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $75,894- $98,894 per year. The base pay for this role in all other locations is: $67,813 - $89,004 per year. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

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.

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.
• BSN
• Licensed Master Social Worker or Licensed Clinical Social Worker
• CCM Certification
• Complex Case Management certification

This is an authentic Oscar Health job opportunity.

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): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

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 ([e-mail]) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy .

Oscar Health is authorized to do business in many, but not all, states. If you are not located in or willing to relocate to a state where Oscar is registered, you will not be eligible for employment. The approved states for this role are listed in the job posting.

Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file.

As set forth in Oscar Health’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.