CCM Case Manager

This is a fully remote position, open to applicants in Georgia.

📋 Description

• Collaborate with various teams at Oscar to ensure the delivery of exceptional care and enhance member health outcomes.

• Educate members on health conditions, hospital discharges, medical procedures, and newly prescribed medications.

• Coordinate care across inpatient, outpatient, emergency room, and home-care environments.

• Work alongside members and healthcare providers to navigate intricate health challenges and develop personalized care plans.

• Evaluate and address Social Determinants of Health by connecting members with customized community support resources.

• Offer crisis intervention support and advocate for members to overcome barriers to care and ensure treatment compliance.

• Interact with members via phone, secure messaging, or in-person meetings.

• Uphold strict confidentiality and maintain high professional standards.

• Contribute to initiatives aimed at process improvement and participate in new pilot programs.

• Adhere to relevant laws and regulations while performing additional duties as assigned.

⛳️ Requirements

• A minimum of 2 years of clinical experience in hospital, outpatient, or community-based care management.

• At least 2 years of experience working directly with patients suffering from chronic medical conditions, including diabetes, COPD, or hypertension.

• A minimum of 1 year of experience in Care Coordination and Navigation.

• An active, unrestricted RN license from the United States in [state], or an active compact multistate unrestricted RN license, or a Master of Social Work (MSW) from a nationally accredited school approved by the Council on Social Work Education.

• Additional qualifications such as BSN, Licensed Master Social Worker, Licensed Clinical Social Worker, CCM Certification, case management experience, complex case management certification, and bilingual Spanish skills are considered advantageous.

🏝️ Benefits

• 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.

• Participation in a 401(k) plan.

• Life and disability insurance.

• Paid wellness time and reimbursements.

• Occasional travel for team meetings and company events.