Senior Manager, Clinical

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