Senior Manager, Clinical at Oscar Health

Atlanta, Georgia, United States -

Full Time

Start Date

Immediate

Expiry Date

26 Jan, 26

Salary

156450.0

Posted On

28 Oct, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clinical Performance, Cross-Functional Collaboration, Team Leadership, Data Analysis, Performance Management, Coaching, Process Improvement, Regulatory Compliance, Quality Auditing, Case Management, Employee Engagement, Communication, Technology Proficiency, Healthcare Knowledge, Project Management, Lean Six Sigma

Industry

Insurance

Description

Hi, we're Oscar. We're hiring a Senior Manager, Clinical to join our Case Management 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: You will drive clinical performance within their own department and the departments they serve. You will collaborate cross-functionally with all levels of leadership to propose initiatives to drive the achievement of department and organizational objectives. You will lead and grow clinical teams through direct leadership of leaders and front-line staff, implementing processes and leveraging performance data to move department objectives forward. You will report into the Associate Director, Clinical. Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $119,200 - $156,450 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities: Review and maintain, based on regulatory, accreditation, and organizational requirements, policies and procedures defining the completion of all department functions to ensure they meet the needs of our members, providers and internal/external stakeholders. Ensure team work is completed within established in accordance with department policies and procedures, regulatory and accreditation requirements. Monitor team performance. Engage with MDI, and understand leading / lagging measures across throughput and clinical outcomes. Analyze data to identify performance trends/opportunities for improvement and ensure they are aligned to overall strategy. Work with data analytics to ensure productivity and quality data provides actionable insights on team/individual performance against goals. Drive a culture of accountability and recognition that aligns with department objectives and increases employee engagement. Provide coaching, development and performance management to frontline staff and leaders, evaluating performance against goals throughout the year. Compliance with all applicable laws and regulations Other duties as assigned Requirements: Bachelor's degree in Nursing (RN) or Master Degree in Social Work 6+ years of experience in healthcare, science, related field, or medical assistance in a payer or healthcare setting 5+ years experiencing managing/overseeing employees in a healthcare setting 3+ years of experience working in production/operations including case prioritization/case triage 1+ years leading process improvement initiatives or large scale projects Working knowledge of NCQA and state/federal regulatory requirements for the areas served by the team Bonus points: Proficiency using case ticketing systems such as Jira, Medecision, and/or Appian to prioritize and document team activities. Proficiency in creating and working with Google Sheets, Slides, Docs and using applications to create presentations to stakeholders, and senior leadership. Experience communicating with senior leadership in a live (virtually or in-person) setting or by email or electronic communication. Strong computer literacy, able to work effectively in multiple platforms Experience performing quality of care investigations or quality auditing for a healthcare organization. Experience leading employees and presenting to large groups in a virtual environment. Experience implementing process improvement strategies/Lean Six Sigma This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. 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 (accommodations@hioscar.com) 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 Notice to Job Applicants.

Responsibilities

Drive clinical performance within the department and collaborate with leadership to propose initiatives. Lead and grow clinical teams, implementing processes and leveraging performance data to achieve objectives.