Care Navigation Nurse
WFA Digital Insight
The demand for skilled nursing professionals in the remote healthcare industry has grown exponentially, with a significant rise in job postings for care navigation specialists. As the healthcare sector continues to evolve, companies like Oscar are at the forefront of innovation, leveraging technology to deliver high-quality patient care. With the ability to work remotely and make a meaningful impact on patients' lives, this role is particularly appealing to those seeking a challenging and rewarding career. Candidates should be prepared to demonstrate their clinical expertise, as well as their ability to work independently and collaboratively as part of a remote team.
Job Description
About the Role
The Care Navigation Nurse plays a vital role in coordinating care for patients across various settings, including inpatient, outpatient, and post-acute care. This role requires a unique blend of clinical expertise, communication skills, and the ability to work effectively in a remote environment. As a Care Navigation Nurse at Oscar, you will be part of a dynamic team that is dedicated to delivering exceptional patient care and improving health outcomes.The Care Navigation team is responsible for sourcing and routing patients to medically appropriate care, verifying network gaps, and escalating issues to stakeholders. This role involves extensive clinical knowledge, initiative, and problem-solving skills to navigate complex patient needs. You will also provide ongoing clinical education to non-clinical teams, ensuring that they have the necessary foundation to provide high-quality support to patients.
What You Will Do
- Coordinate care across various settings, including inpatient, outpatient, and post-acute care
- Develop and implement care plans for patients with complex needs
- Proactively reach out to hospital case managers to assist with discharge planning
- Communicate with patients via phone or secure messaging to provide education on health conditions, new medications, and procedures
- Identify and address potential gaps in care, ensuring seamless transitions between settings
- Collaborate with stakeholders to escalate issues and resolve concerns
- Provide ongoing clinical education to non-clinical teams
- Participate in quality improvement initiatives to enhance patient care and outcomes
- Utilize digital tools and platforms to manage patient data and coordinate care
- Stay up-to-date with industry developments, best practices, and regulatory requirements
What We Are Looking For
- Active, unrestricted RN licensure from the United States
- Ability to obtain additional state licenses to meet business needs
- 3+ years of clinical experience in hospital, outpatient, or community-based care management
- 3+ years of experience in care coordination and navigation
- Strong clinical knowledge and problem-solving skills
- Excellent communication and interpersonal skills
- Ability to work independently and collaboratively as part of a remote team
- Proficiency in digital tools and platforms, including electronic health records and care coordination software
- CCM Certification (preferred but not required)
Nice to Have
- BSN or higher degree in nursing
- Working knowledge of Milliman Guidelines
- Behavioral health experience
- Experience working in a remote or virtual care setting
Benefits and Perks
- Competitive compensation package
- Comprehensive benefits, including medical, dental, and vision coverage
- 401(k) plan participation
- Paid time off and holidays
- Opportunities for professional development and growth
- Remote work arrangement with flexible scheduling
- Access to digital tools and platforms to support care coordination and patient management
- Collaborative and dynamic work environment
- Recognition and rewards for outstanding performance and contributions
How to Stand Out
- Make sure to highlight your clinical expertise and experience in care coordination and navigation, as these are essential skills for this role.
- Be prepared to demonstrate your ability to work independently and collaboratively as part of a remote team.
- Emphasize your proficiency in digital tools and platforms, including electronic health records and care coordination software.
- Show your passion for delivering high-quality patient care and improving health outcomes.
- Prepare examples of how you have navigated complex patient needs and coordinated care across various settings.
- Be ready to discuss your experience with quality improvement initiatives and how you have contributed to enhancing patient care and outcomes.
- Research Oscar's mission, values, and culture to demonstrate your alignment with the company's vision and goals.
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