Hi, we’re Oscar. We’re hiring a Clinical Review Team, Nurse Manager, to join our Clinical Review team.

Oscar is the first health insurance company built around a full stack technology platform and a 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 Nurse Manager manages supervisors and supports a team of utilization review nurses, oversees day-to-day nurse operations, performs quality audits and performance reviews, as well as conducts some medical necessity review with medical appropriateness of inpatient and outpatient services by reviewing clinical information and applying evidence-based guidelines alongside the nursing team. The role works closely with Oscar providers, internal team members and internal/external key stakeholders as the point of contact and for collaboration.

You will report to the Clinical Review Team, Senior Nurse Manager.

This is a remote / work-from-home role. You must reside in one of the following states: Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

The base pay for this role is: $113,600 - $149,100 per year. You are also eligible for employee benefits, participation in Oscar’s unlimited vacation program, and annual performance bonuses.

Responsibilities

• Demonstrate the highest level of professionalism, accountability, and service in your interactions with Oscar teammates, customer service, providers, and members
• Use Oscar tools and processes to perform and properly track all utilization reviews, as well to refer members for further care engagement when needed
• Build strong relationships with the cross-functional company partners by collaborating on process improvement initiatives
• Collect and provide feedback accordingly to the team and leadership including both internal and external stakeholders
• Strategize with senior leadership and drive process improvement
• Develop the nursing team and drive team as well as individual success
• Have a working familiarity with applicable regulatory and accreditation requirements
• Perform and participate in quality improvement activities as requested as well as support quality auditing
• Maintain continued professional growth and education to meet continuing education requirements and demonstrate knowledge & understanding of current nursing care practice

Qualifications

• Active, unrestricted RN licensure from the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC)
• Bachelors - Nursing or Graduate of Accredited School of Nursing
• Ability to obtain additional state licenses as needed for Oscar’s growth (with Oscar’s support)
• 2+ years of utilization review experience at a managed care plan or provider organization and /or healthcare experience (including at least three years in clinical practice in an acute care setting) and
• 3+ years of managerial experience

Bonus Points

• Masters of Science in Nursing
• Ability to navigate technology; able to learn new software tools
• Building, coaching, developing teams.