Complex Case Management Clinical Supervisor
New
O
Oscar HealthHealth Insurance
Arizona; Florida; Georgia; or Texas.Full-TimeManager
Salary$91,908.00 - $120,629.25 per year
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Job Details
- Languages
- Spanish
- Experience
- 3+ years of experience in a healthcare setting as a nurse or social worker; 1+ years of case management experience at a managed care plan or provider organization
- Required Skills
- SQLJiraMicrosoft Excel
Requirements
- 3+ years of experience in a healthcare setting as a nurse or social worker.
- 1+ years of case management experience at a managed care plan or provider organization.
- Active, unrestricted Nursing license (RN) in state of hire or Masters in Social Work (MSW).
- Ability to obtain additional licensure as needed.
- Complex Case Management knowledge.
- NCQA knowledge (preferred).
- 1+ year of previous leadership experience in a healthcare environment (preferred).
- Working knowledge of Milliman Care Guidelines or familiarity with UM guidelines (preferred).
- CCM certification (preferred).
- BSN or LMSW/LCSW (preferred).
- Strong proficiency navigating Excel, JIRA, and SQL (preferred).
- Bilingual in Spanish (preferred).
Responsibilities
- Lead team and department meetings and participate in operations management sessions.
- Act as the clinical expert and resource for the team and other departments.
- Promote team vision and strategy to achieve department goals.
- Lead continuous improvement activities for team development.
- Manage outcomes, monitor dashboards, and track operational KPIs.
- Conduct root-cause analysis and construct action plans for operational issues.
- Manage daily team needs, personnel issues, payroll, and attendance.
- Provide coaching and individual QI feedback to team members.
- Ensure compliance with all applicable laws and regulations.
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