Oscar Health Insurance logo
Oscar Health Insurance

Operating on the belief that healthcare is broken, Oscar Health Insurance is on a mission to reinvent and humanize the industry by combining technology, design,

Case Management RN

Location

United States

Posted

5 days ago

Salary

$33 - $43 / hour

Seniority

Mid Level

No structured requirement data.

Job Description

Case Management RN

Oscar Health Insurance

Role Description Hi, we're Oscar. We're hiring a Case Management RN to join our Clinical Concierge 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: - Educate members on improving health outcomes - Assist with transitions from care settings - Participate in process improvement and other pilot programs as they arise - Work with support teams to ensure care for our members You will report into the Case Management Supervisor. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $32.60 - $42.79 per hour. You are also eligible for employee benefits, monthly vacation accrual at a rate of 15 days per year. Responsibilities - Help coordinate care across a variety of settings (inpatient, outpatient, post acute, ER, home care) - Reach out to members undergoing difficult health challenges and develop care plans - Reach out to hospital case managers to assist with discharge planning - Communicate with members by phone or secure messaging to provide education on health conditions, new medications, and procedures - Compliance with all applicable laws and regulations - Other responsibilities as assigned Requirements - Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license - Obtain additional state licenses to meet our needs - 2+ years of clinical experience to include hospital, outpatient or community-based care management - 1+ years of experience in Care Coordination and Navigation Bonus Points - BSN - Working knowledge of Milliman Guidelines - CCM Certification - Behavioral Health experience Benefits - 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

Related Job Pages

More Case Coordinator Jobs

Job Description: Arbitration & Mediation Case Filing Supervisor Location: Buffalo, NY, United States The American Arbitration Association is an equal opportunity employer (EEO) and considers all employees and applicants for positions without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, marital status, or status as a covered veteran in accordance with applicable federal, state and local laws. If you are unable to complete your application, you may request a disability accommodation and submit your information through an alternative method by contacting the Human Resources Department. Description Case Filing Supervisor (2026-77) Overview The American Arbitration Association (AAA) is seeking a Case Filing Supervisor to oversee a team responsible for the accurate and efficient entry of case filings into our PRISM case management system. This role manages a team of Case Filing Specialists, ensuring compliance with filing standards and case processing procedures while also handling a caseload of deficient or incomplete filings. The ideal candidate will bring strong leadership, communication, and data-driven process improvement skills to support high-quality case administration and excellent internal/external service. Work Environment This position offers a remote work arrangement; candidates must reside at a U.S. location within 125 miles of their assigned office location. Compensation will be determined based on geographic location. Compensation - San Antonio, TX; Miami, FL: $79,000 – $84,000 - Fresno, CA; Dallas, TX; Atlanta, GA; Buffalo, NY: $84,000 – $89,000 - Houston, TX; Minneapolis, MN; Johnston, RI; Voorhees, NJ: $85,000 – $90,000 - Chicago, IL; Philadelphia, PA, Voorhees, NJ: $89,000 – $95,000 - Los Angeles, CA; Boston, MA: $93,000 – $98,000 - San Francisco, CA; New York City, NY: $99,000 – $105,000 This position is also eligible for an annual performance-based incentive. Our competitive compensation package includes medical, dental, orthodontia, and vision coverage, a student loan repayment program, a 403(b) retirement plan with substantial company match, discounted pet insurance, and generous paid time off. Qualifications - Bachelor’s degree in business or related field with 2–4 years of relevant experience, including some supervisory experience; or - Associate’s degree with 4–6 years of relevant experience, including 2+ years in a supervisory role; or - An equivalent mix of education and experience that demonstrates the required skills and competencies for the position. - Excellent verbal and written communication skills, with the ability to tailor messaging to diverse audiences and convey complex information clearly. - Demonstrated ability to supervise, mentor, and develop team members, including setting goals, providing feedback, and managing performance. - Strong analytical and critical thinking skills to address practical problems, make sound decisions, and develop effective solutions in a dynamic work environment. - Intermediate to advanced proficiency in case management systems, Microsoft Office suite (particularly Excel for reporting), and HRIS/HRMS software applications. - Knowledge of best practices in case filing and data entry processes, with the ability to identify inefficiencies and implement improvements to enhance accuracy and productivity. About Us The American Arbitration Association (AAA), recognized among The NonProfit Times' 50 Best Nonprofits to Work For, offers a dynamic, fast-paced environment where excellence meets opportunity. Our organization leads arbitration and mediation across diverse industries, providing professionals with unique exposure to multiple business sectors and conflict resolution practices. We foster growth through collaboration with experienced legal professionals and invest in our team through comprehensive professional development programs. At the AAA, we combine challenging work with meaningful recognition in an environment where merit drives success and learning never stops. The American Arbitration Association is an equal opportunity employer (EEO) and considers all employees and applicants for positions without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, marital status, or status as a covered veteran in accordance with applicable federal, state and local laws.

New York
$79K - $105K / year
Full TimeRemoteTeam 5,001-10,000H1B Sponsor

Role Description Responsible for accurate, detailed, and thorough medical billing processes. Working in coordination with the team Lead, the Supervisor, and Management. The coordinator will work collaboratively with patients and office team members to ensure that billing practices are complete and accurate. The ideal candidate will be someone who has a strong desire to work individually while meeting the needs of a national organization. An important key requirement is the self-accountability to drive success in a virtual team environment. This position is a remote role with the ability to sit within any US locality. Key Responsibilities - Perform duties as assigned in a professional demeanor, which includes interacting with insurance plans, clinics, patients, and team members as needed. - Maintain current information on correct and lawful practices for billing payers. - Participate in the daily RCM processes, monitoring for accurate and timely completion of team duties. - Maintain up-to-date information on RCM process with National SOPs, processes, and policies. - Utilize all available job aids, websites, programs, and resources provided. - Support leadership with daily, weekly, monthly reporting needs as required. - Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership. - Identify and communicate with Team Lead / Supervisor any issues including system access, payor behavior, account work-flow inconsistencies or any other RCM related opportunities. - Other duties as needed. Qualifications - High school diploma or GED equivalent required. - Minimum of two years of medical facility or medical office billing experience. - Ability to work both in a team environment and independently. - Experience utilizing Microsoft Office products including Outlook, Excel, and Teams. - Experience with automated billing systems preferred. - Knowledgeable of full revenue cycle processes, with insurance companies, Medicare, and Medicaid. - Strong attention to detail. - Demonstrates awareness, inclusivity, sensitivity, humility, and experience in working with individuals from diverse ethnic backgrounds, socioeconomic statuses, sexual orientations, gender identities, and other various aspects of culture. Physical Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - While performing the duties of this job, the employee is regularly required to sit, stand, bend, talk, and hear. - The employee is frequently required to walk. - The employee must be able to lift and/or move objects up to 25 pounds. - Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Benefits - Medical, dental, and vision insurance. - AD&D, short and long-term disability, and life insurance. - 401k retirement savings with employer match. - Paid parental leave. - Paid time off. - Holiday pay. - Employee Assistance Program.

United States
$20 - $24 / hour
Full TimeRemoteTeam 201-500Since 1980H1B No Sponsor

Role Description An ECM Coordinator III supports department staff with administrative tasks related to a member’s medical condition(s), department case work, communication with internal and external stakeholders, and manage audits. This role will engage with members to offer support and resources related to their medical condition(s) through Allied Care. Essential Functions - Facilitate reviews, referrals, and outreach for referral-based proprietary strategies as well as engaging with members across Medical Management products. - Document all engagement accurately and concisely within the Microsoft Customer Relationship Management (CRM) system. - Manage escalated and time sensitive case management questions received from members, broker relationships, and internal and external Allied stakeholders. - Collaborate with strategic vendor partners to provide supportive services and support to members. - Lead and facilitate claims auditing in conjunction with ECM Coordinators. - Complete department auditing related to daily tasks to ensure accuracy and identify escalations. - Identify impactful scenarios through appropriate closing summaries in timely fashion. - Share impactful scenarios with the department’s leadership team to deliver to internal departments, such as Sales, Operations, and Executive leadership. - Identifying escalations for department leadership team, as appropriate. - Other duties as assigned. Qualifications - Bachelor’s Degree or equivalent work experience, required. - At least 3-5 years of administrative support experience required. - Focus on patient-provider engagement, needs assessments, coordination of care, and or patient treatment adherence within the healthcare or social service industry preferred. - Understanding of intermittent medical terminology such as CPT, HCPC, and diagnostic codes. - Understanding of basic benefit plan design terminology such as deductible, out-of-pocket, prescription drugs, physical medicine services, etc. - Strong verbal and written communication skills. - Strong analytical and problem-solving skills. Requirements - Accountability. - Communication. - Customer Service Orientation. - Functional/Technical Skills. - Quality Focus. - Time and Task Management. Physical Demands This is a standard desk role requiring extended sitting and computer work. Work Environment Remote. Benefits - Competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance. - Generous Paid Time Off. - Tuition Reimbursement. - EAP. - Technology Stipend.

United States
$23 - $24 / hour
Job Closed
Gainwell Technologies logo

Medicaid Case Management Supervisor

Gainwell Technologies

Gainwell Technologies is an award-winning digital health technology company that supports the administration of healthcare and human services programs. In past

Role Description Gainwell Technologies is seeking a Medicaid Case Management Supervisor to support day-to-day operational performance, lead team members, and drive process improvements across assigned business areas. This role is responsible for helping formulate operational strategies, improving team performance, securing compliance with policies and procedures, and ensuring resources are used effectively to meet business objectives. The Operations Supervisor will serve as a key leader for the team, providing guidance, coaching, and support while identifying opportunities to improve quality, efficiency, and customer service. This position requires strong people management skills, critical thinking, and the ability to anticipate operational challenges and implement practical solutions. - Supervise, train, mentor, and support employees to ensure operational goals and service expectations are met. - Help formulate and execute strategies that improve departmental performance and operational effectiveness. - Monitor day-to-day activities to ensure compliance with operational policies, procedures, and business requirements. - Identify opportunities to reduce operational costs while maintaining quality and service standards. - Procure, coordinate, and manage materials, tools, and resources needed to support team operations. - Track progress of administrative duties and ensure work is completed accurately and timely. - Promote best practices across all levels of the team to improve consistency, productivity, and service quality. - Build strong teams by encouraging collaboration, teamwork, accountability, and a positive workplace culture. - Anticipate potential issues that may impact successful outcomes and recommend creative, practical solutions. - Support employee engagement by providing clear direction, regular feedback, and ongoing coaching. - Partner with leadership and cross-functional teams to support business objectives and operational priorities. - Ensure customer service standards are met by identifying process gaps and implementing improvements. Qualifications - Paralegal or bachelor’s degree preferred. - At least one year of experience in a supervisory, team lead, or people leadership role. - Prior experience managing, mentoring, or overseeing team members in a professional work environment. - Experience working with, reading, or reviewing legal documents. - Medicaid experience required. - Ability to monitor team performance, create reports, track SLAs/BPIs, and support operational reporting needs. Requirements - Remote position open to candidates located anywhere in the U.S. - Must be willing to work an Eastern Standard Time (EST) schedule: Monday through Friday, 8:00 a.m. to 5:00 p.m. - Video cameras must be used during all interviews, as well as during the initial week of orientation. - To work effectively as a teleworker or hybrid positions with Gainwell, employees must have a broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload. Higher speeds are recommended for optimal performance. - The deadline to submit applications for this posting is August 3, 2026. Benefits - The pay range for this position is $50,600.00 - $72,300.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. - Generous, flexible vacation policy. - 401(k) employer match. - Comprehensive health benefits. - Educational assistance. - A variety of leadership and technical development academies to help build your skills and capabilities.

United States
$50.6K - $72.3K / year