Senior Quality of Care Review Nurse

Job not on LinkedIn

🕒 July 29

🌵 Arizona, Florida, +1 more states – Remote

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💵 $83.6k - $109.8k / year

⏰ Full Time

🟠 Senior

🦅 H1B Visa Sponsor

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Logo of Oscar Health

Oscar Health

1001 - 5000 employees

Founded 2012

⚕️ Healthcare Insurance

🏥 Healthcare

🔥 Funding within the last year

💰 $355M Post-IPO Debt - Oscar Health on 2025-09

Healthcare Insurance • Healthcare

Oscar Health is a technology-driven health insurance company that provides individual, family, and small-group health plans in multiple U. S. states. Oscar combines traditional insurance underwriting with digital-first services — a consumer-facing app, 24/7 virtual urgent care, prescription delivery (including $3 meds in many plans), and dedicated Care Teams — and also operates Oscar Primary Care in some markets. The company emphasizes accessible, affordable, high-quality care and uses AI to improve member experience and care delivery. Insurance policies are underwritten by Oscar's state insurance subsidiaries and the company offers both HMO and other plan types across its markets.

📋 Description

• Reviewing member complaints that need to be escalated immediately • Perform quality of care review to determine whether records or commentary from the provider/facility will be needed • Conduct root cause analyses for adverse events, sentinel events, or potential quality issues • Investigate provider and facility quality of care concerns • Perform annual medical record reviews for selected states • Consult with internal stakeholders to ensure that quality of care needs or members are met • Present quality and performance trend data to organizational stakeholders • Compliance with all applicable laws and regulations

🎯 Requirements

• Licensed Registered Nurse with active, unrestricted license in state of residence • 2+ years of experience as a Registered Nurse • 2+ years experience working in a clinical care setting

🏖️ Benefits

• Health insurance • 401(k) plan participation • Unlimited vacation program • Annual performance bonuses

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