Oscar Health · 23 hours ago
UM Nurse Manager
United States
Full-time
Remote
Mid, Senior Level
$112K/yr - $147K/yr
4+ years expOscar is a health insurance company built around a full stack technology platform focused on serving its members. The UM Nurse Manager will drive clinical and operational performance within the Utilization Management team, ensuring adherence to regulatory requirements and improving departmental quality and productivity metrics.
Health CareHealth InsuranceInsuranceInsurTech
Responsibilities
Play a key role and provide input in creating and maintaining, based on regulatory, accreditation, and organizational requirements, policies and procedures defining the completion of all department functions to help ensure they meet the needs of our members, providers and internal/external stakeholders
Oversee daily operations to ensure team work assignments are completed within established turnaround times and in accordance with department policies and procedures, regulatory and accreditation requirements
Monitor team dashboards, review and analysis of productivity reporting, completion of quality audits and other data to monitor individual and team performance
Maintain expertise on department tools and platforms to inform analysis
Analyze data to identify performance trends/opportunities for improvement and work with data analytics regularly to ensure productivity and quality data provides actionable insights on team/individual performance against goals
Create corrective action plans or performance improvement plans to address identified opportunities
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
Qualification
Required
Bachelor's degree or 4+ years commensurate experience
Active, unrestricted Nursing license (RN) in the state of hire and ability to obtain additional licensure as needed
4+ years of experience in a healthcare setting as a nurse
2+ years of experience in utilization management making clinical decision using milliman care guidelines
1+ years of experience working in production/operations including case prioritization/case triage
2+ years leading a clinical team at a managed care plan or healthcare organization including in a virtual environment
Preferred
Experience performing quality of care investigations or quality auditing or compliance oversight for a healthcare organization
Proficiency using case ticketing systems e.g. Jira or Appian to prioritize & document team activities
1+ years leading and/or implementing process improvement initiatives/Six Sigma or large scale projects
Strong proficiency in creating and working with Google Sheets, Slides, Docs and using applications to create presentations to stakeholders, and senior leadership
Experience in communicating with senior leadership in a live (virtually or in-person) setting or via email- electronic communication
Strong computer literacy, able to work effectively in multiple platforms
Experience leading employees and presenting to large groups in a virtual environment
Working knowledge of NCQA and state/federal regulatory requirements for the areas served by the team
Benefits
Employee benefits
Participation in Oscar's unlimited vacation program
Annual performance bonuses
Medical, dental, and vision benefits
11 paid holidays
Paid sick time
Paid parental leave
401(k) plan participation
Life and disability insurance
Paid wellness time and reimbursements
Company
Oscar Health
Oscar is a health insurance company that offers individual and family plans, medicare advantages, and small group products.
1001-5000 employees
H1B Sponsorship
Oscar Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (19)
2024 (24)
2023 (22)
2022 (36)
2021 (13)
Funding
Current Stage
Public CompanyTotal Funding
$1.99BKey Investors
Tiger Global ManagementAlphabetFounders Fund
2025-09-16Post Ipo Debt· $355M
2021-03-03IPO
2020-12-17Private Equity· $140M
Leadership Team
Mark Bertolini
Chief Executive Officer
Steven B. Kelmar
Executive Vice President & COS
Recent News
2026-01-17
2026-01-16
2026-01-16
Company data provided by crunchbase