CCM Case Manager

Posted 3 Days Ago
Be an Early Applicant
Atlanta, GA, USA
In-Office
68K-99K Annually
Junior
Healthtech • Insurance
Give people power over their healthcare.
The Role
Coordinate care across inpatient, outpatient, emergency, and home settings; create personalized care plans; assess social determinants of health; connect members with community resources; provide education, crisis intervention, advocacy, and care navigation. The role requires collaboration with members and providers, chronic-condition expertise, regulatory compliance, and participation in process improvement initiatives.
Summary Generated by Built In

Hi, we're Oscar. We're hiring a ((TITLE)) to join our ((TEAM NAME)).

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 our Manager, Clinical Programs.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; 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 in the states of California, Connecticut, New Jersey, New York, and Washington is: $75,348 - $98,894 per year. The base pay for this role in all other locations is: $67,813 - $89,005 per year. You are also eligible for employee benefits, monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

  • Coordinate care across settings (inpatient, outpatient, ER, and 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 create 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 by 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 responsibilities 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 in [state], 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.

Bonus points:

  • BSN
  • Licensed Master Social Worker or Licensed Clinical Social Worker
  • CCM Certification
  • Case Management experience
  • Complex Case Management certification
  • Bilingual skills (Spanish)

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 ([email protected]) 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.

Skills Required

  • At least 2 years of clinical experience in hospital, outpatient, or community-based care management
  • At least 2 years of direct experience working with patients with chronic medical conditions, including knowledge of disease trajectories, treatment regimens, and symptom management
  • At least 1 year of experience in care coordination and navigation
  • Active, unrestricted U.S. RN license in the applicable state, or an active compact multistate unrestricted RN license
  • Master of Social Work from a nationally accredited school approved by the Council on Social Work Education
  • BSN
  • Licensed Master Social Worker or Licensed Clinical Social Worker credential
  • CCM certification
  • Case management experience
  • Complex case management certification
  • Bilingual Spanish skills

Oscar Health Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Oscar Health and has not been reviewed or approved by Oscar Health.

  • Healthcare Strength Employer-sponsored medical coverage for employees and their families with mental-health support is prominently offered. Wellness programming and digital care access add to perceived strength.
  • Parental & Family Support Paid parental leave of 10+ weeks, backup care, and family-forming support (including fertility and adoption benefits) are part of the package. Reproductive‑loss leave is also noted.
  • Leave & Time Off Breadth Multiple time‑off options, wellness days, and an unlimited vacation program for some roles are described. Paid holidays, paid sick time, and a long‑tenure sabbatical broaden time‑away choices.

Oscar Health Insights

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The Company
HQ: New York, NY
2,400 Employees
Year Founded: 2012

What We Do

Oscar Health, Inc. (NYSE: OSCR) is a leading consumer health company that gives people power over their healthcare. Oscar Health serves millions of consumers, employers, brokers, and partners through Oscar Insurance, Lucie Health Marketplace, and Trove Group. Together these businesses deliver exceptional lifestyle products and technology platforms that make healthcare easy to choose, use, and experience.

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