Clinical Support Specialist

Hi, we're Oscar. We're hiring a Clinical Support Specialist to join our Clinical Support Services 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

As a Clinical Support Specialist, you will provide care coordination for the low acuity interventions with our members. Additionally, you will be the “Clinical Triage Desk” where they field inbound phone calls for the Clinical Care Team. Through assistance with care coordination and care routing, you will help members reach their optimum health goals in the most cost-effective way.

You will report to the Associate Operations Manager of Clinical Support & Care Navigation

Work Location:

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. 

If you live within commutable distance to our Tempe office (off the 101 at University Dr), we ask you to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.

You must reside in one of the following states: Alabama, Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

Pay Transparency:

The pay for this role is: $22.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 10 days per year.

Responsibilities

• Support the care coordination of lower acuity members across a variety of settings (hospitals, outpatient clinics, home care, supply vendors, dialysis) while maintaining strict confidentiality
• Work in direct collaboration with the internal and external case managers to support member needs
• Obtain prescriptions and clinical documents from providers to assist members with obtaining care (e.g surgeries/hospital stay)
• Use critical thinking skills to anticipate the needs of each member
• Send HIPAA authorization requests and other documents to facilities/hospitals to help guide members INN
• Field and support or assess inbound phone calls from members and providers
• Build and manage transplant contracts with appropriate vendors
• Support in the triage of case management programs 
• Collaborate cross-departmentally to create a positive member experience.
• Compliance with all applicable laws and regulations 
• Other duties as assigned

Qualifications

• 1+ years of experience with care coordination and navigation in a healthcare setting

• 1+ years of experience using a Chromebook and Google Workspace

• 3+ years of experience communicating directly with patients/members

Bonus Points

• Certified as a Medical Assistant
• Bilingual in English and Spanish
• Experience working in a collaborative environment

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.

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.