Director of Clinical Case Management

Healthcare is big and complicated. At Oscar we also believe the current insurer, physician, and patient model is broken and we have the unique privilege and responsibility to rebuild it. While we continue to disrupt traditional insurance through technology, we understand that health care is still very much about human interactions. The Oscar Concierge Team lives at the intersection of technology and member services and is a foundational element of our Care Delivery vision.
Concierge teams consist of clinicians and non-clinicians aligned together in building relationships with our members, identifying their needs, and guiding them to more efficient healthcare and ultimately healthier outcomes. Our teams allow us to deliver a more personal experience to educate and empower our members. Learn more about Oscar Concierge here.
Based at our Health Hub in Tempe, you will also be working closely with leaders across all member facing services to develop how our Concierge model can drive a differentiated healthcare experience for our members. With our sizeable membership growth, the Hub has been the fastest growing part of our organization. As we continue to grow within existing markets and enter new states, you will be critical voice in our overall Care Delivery growth strategy.
As our Director of Clinical Informatics and Concierge Case Management, your role will be to lead our case management team of nurse leads, team nurses, social workers, and clinical care guides. You will be responsible for:
Finding ways we can improve members' health while balancing results and cost effectiveness
Ensuring members receive exceptional service and their voice is well represented in all we do as an organization
Managing the Case Management team on a daily basis from a personnel and goaling perspective
You will work closely with the Arizona Medical Director and Operations Managers to achieve these goals. We all work side by side in a collaborative, energetic, and creative environment.
Your day-to-day
Review the quality of nurse support of our members
Provide clinical guidance and support
Design systematic solutions to improve clinical support for our membership
Bring creative solutions that allow for nurses to thrive in a tech company
Work with cross departmental stakeholders to address escalated member needs
Interface with outside health system case management leaders to improve coordination of care.
Provide oversight of scheduling, licensing, and meeting operational KPIs
In your first month, you will:
Experience being a Nurse Concierge hands-on, learning the details of the job
Develop full grasp of existing operations including our mission, vision for member
experience, company culture and operational needs
Establish reporting relationship with your nurses, including coordinating nurse schedules
Form a point of view on what is working and what has room for improvement
In your first 6-months, you will:
Work with our Arizona Medical Director and Clinical Operation Managers to improve processes and workflows for the Nurse Concierge team
Develop metrics driven, team-centric operations and hold your team accountable to goals
Spot patterns in how our members need care, find solutions, and affect change
On an ongoing basis, you will:
Set a strong, positive leadership tone and create a great team-based work environment
Develop the success of your team through coaching, clinical escalation
support, process improvement and vision-setting
Deliver on KPIs involving both member experience, satisfaction, and health outcomes, as well as employee experience and satisfaction
Ultimately, ensure our members receive the best experience possible
Active, unrestricted RN license in Arizona, New York, Texas, New Jersey and/or California and are willing to obtain additional state licenses as needed
5+ years caring for patients in inpatient/outpatient or care management settings
5+ years of experience leading and supporting a team
You think on your feet and thrive in a fast-paced service environment with many moving pieces
You are a systematic, analytical and strategic thinker -- If there is a problem you jump in and tackle it with data
You believe that a team is stronger than the sum of its individual contributors, and understand how team dynamics are core to enhancing our member experience
You are great at self-learning and have a strong service mentality
Bonus if you have experience with case management programs
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we work to cultivate an environment where exceptional people can be their most authentic selves and find both belonging and support. We're on a mission to change healthcare -- an experience made whole by your unique background and perspectives.
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.
Pay Transparency Policy: Oscar's Pay Transparency Policy 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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